Characteristics of psychiatric hospitals associated with length of stay in Japan

Abstract

Objective: Average length of inpatient stay at psychiatric hospitals in Japan has been consistently longer than that in any other developed country, and was 330 days in 1996. Although some reforms have been implemented with the intention of decreasing length of stay (LOS), appreciable reductions have not been achieved. The present study examined hospital characteristics associated with length of stay in regional psychiatric hospitals in Japan, in order to identify variables that might help to reduce LOS. Method: This cross-sectional study analysed the complete database of one district in Japan. Analyses were conducted using aggregate data from 24 hospitals. Multiple regression analysis was performed to determine hospital characteristics influencing LOS in psychiatric hospitals. Results: Significant positive associations were identified between LOS and two hospital characteristics: inpatient capacity; proportion of involuntary admissions. Negative associations were observed for three variables: number of outpatients; human resources in terms of healthcare professionals available in each hospital; community activity. Multiple linear regression analysis for the 24 hospitals revealed that number of outpatients and proportion of patients receiving public aid were independently associated with shorter LOS, while proportion of involuntary admissions was independently associated with longer LOS. A negative association between human resources in terms of number of healthcare professionals and LOS was suggested. Conclusion: Several hospital characteristics are associated with LOS in psychiatric hospitals. Factors identified in this study offer insights into directions for effective psychiatric health policy to reduce LOS.