Joseph C Blader1. 1. Department of Psychiatry and Behavioral Science, Stony Brook University, State University of New York, School of Medicine, Stony Brook, USA. joseph.blader@stonybrook.edu
Abstract
CONTEXT: Data from facility-level surveys indicate that US inpatient psychiatric admissions rose in 2004, from their trough in 1998 to 2000, mainly in acute care settings. Patient-level factors, including age, admission type, diagnoses, length of stay, and payment source, are vital to understanding hospitalization trends. OBJECTIVE: To evaluate trends in acute care hospitalizations for primary psychiatric diagnoses between 1996 and 2007 in relation to patient-level variables. Design, Setting, and PARTICIPANTS: The yearly National Hospital Discharge Survey furnished demographic, clinical, and payment data on a probability sample of discharges from short-stay facilities (mean [SD], 448.33 [19.66]), along with weights for extrapolation to population estimates. Discharges with a primary psychiatric diagnosis (mean [SD], 19 535 [2615]) were identified among children (aged 5-13 years), adolescents (aged 14-19 years), adults (aged 20-64 years), and elderly individuals (≥65 years). MAIN OUTCOME MEASURES: Annual rates of discharges and total days of inpatient care associated with primary psychiatric diagnoses for each age group. RESULTS: Psychiatric discharges increased for children from 155.54 per 100 000 children in 1996 to 283.04 per 100 000 in 2007 (P = .003); for adolescents, from 683.60 to 969.03 per 100 000 (P = . 001); and for adults, from 921.35 to 995.51 per 100 000 (P = .003) but declined for elderly individuals from 977.63 to 807.55 per 100 000 (P < .001). Total inpatient days increased for children (1845 days per 100 000 in 1996 to 4370 days in 2007; P = .02) and for adolescents (5882 days per 100 000 in 1996 to 8247 days in 2007; P < .001) but decreased for elderly patients (10 348 days per 100 000 in 1996 to 6517 days; P < .001). The proportion of inpatient days paid by private sources declined among children (36%-21%), adolescents (52%-22%), and adults (35%-23%; all P < .001). CONCLUSIONS: Inpatient discharges in short-stay facilities with a primary psychiatric diagnosis rose between 1996 and 2007, most dramatically for youth, but decreased among elderly individuals. Private funding bore a declining share of costs.
CONTEXT: Data from facility-level surveys indicate that US inpatient psychiatric admissions rose in 2004, from their trough in 1998 to 2000, mainly in acute care settings. Patient-level factors, including age, admission type, diagnoses, length of stay, and payment source, are vital to understanding hospitalization trends. OBJECTIVE: To evaluate trends in acute care hospitalizations for primary psychiatric diagnoses between 1996 and 2007 in relation to patient-level variables. Design, Setting, and PARTICIPANTS: The yearly National Hospital Discharge Survey furnished demographic, clinical, and payment data on a probability sample of discharges from short-stay facilities (mean [SD], 448.33 [19.66]), along with weights for extrapolation to population estimates. Discharges with a primary psychiatric diagnosis (mean [SD], 19 535 [2615]) were identified among children (aged 5-13 years), adolescents (aged 14-19 years), adults (aged 20-64 years), and elderly individuals (≥65 years). MAIN OUTCOME MEASURES: Annual rates of discharges and total days of inpatient care associated with primary psychiatric diagnoses for each age group. RESULTS:Psychiatric discharges increased for children from 155.54 per 100 000 children in 1996 to 283.04 per 100 000 in 2007 (P = .003); for adolescents, from 683.60 to 969.03 per 100 000 (P = . 001); and for adults, from 921.35 to 995.51 per 100 000 (P = .003) but declined for elderly individuals from 977.63 to 807.55 per 100 000 (P < .001). Total inpatient days increased for children (1845 days per 100 000 in 1996 to 4370 days in 2007; P = .02) and for adolescents (5882 days per 100 000 in 1996 to 8247 days in 2007; P < .001) but decreased for elderly patients (10 348 days per 100 000 in 1996 to 6517 days; P < .001). The proportion of inpatient days paid by private sources declined among children (36%-21%), adolescents (52%-22%), and adults (35%-23%; all P < .001). CONCLUSIONS: Inpatient discharges in short-stay facilities with a primary psychiatric diagnosis rose between 1996 and 2007, most dramatically for youth, but decreased among elderly individuals. Private funding bore a declining share of costs.
Authors: Samantha Meltzer-Brody; Anna R Brandon; Brenda Pearson; Lynne Burns; Christena Raines; Elizabeth Bullard; David Rubinow Journal: Arch Womens Ment Health Date: 2013-11-08 Impact factor: 3.633
Authors: Colleen L Barry; Alyna T Chien; Sharon-Lise T Normand; Alisa B Busch; Vanessa Azzone; Howard H Goldman; Haiden A Huskamp Journal: Pediatrics Date: 2013-02-18 Impact factor: 7.124
Authors: Brady G Case; David N Bertollo; Eugene M Laska; Lawrence H Price; Carole E Siegel; Mark Olfson; Steven C Marcus Journal: Biol Psychiatry Date: 2012-10-08 Impact factor: 13.382
Authors: Kevin M Conley; Delmas J Bolin; Peter J Carek; Jeff G Konin; Timothy L Neal; Danielle Violette Journal: J Athl Train Date: 2014 Jan-Feb Impact factor: 2.860
Authors: Shannon N Saldaña; Brooks R Keeshin; Anna M Wehry; Thomas J Blom; Michael T Sorter; Melissa P DelBello; Jeffrey R Strawn Journal: Pharmacotherapy Date: 2014-07-03 Impact factor: 4.705