Length of stay among multi-ethnic psychiatric inpatients in the United Kingdom

Abstract

BackgroundDisproportionate rates of psychiatric admissions and length of stay (LOS)11Length of stay is a term used to describe the duration of time in which an individual is hospitalized. have been repeatedly observed among Black and Minority Ethnic (BME)22Black and Minority Ethnic Groups is a term used to describe people of non-white descent or non-majority ethnicity. groups with severe mental illness (SMI), specifically those of Black Caribbean heritage. Commensurate understanding of the mechanisms underlying this observation remains poorly understood, warranting further attention. MethodA quasi-experimental retrospective cohort design was used to examine 11,617 psychiatric inpatient admissions in London, U.K. Variations in LOS across four ethnic groups (i.e., Black Caribbean, Black African, White British, and Asian) were recorded. Multivariate logistic regression was then used to determine the extent to which demographic (age, marital status, gender, homeless at admission), clinical (primary diagnosis, substance misuse), and behavioral variables (violent behavior, deliberate self-harm, victimization) explained any observed differences across ethnic groups. ResultsUnivariate analyses revealed that while Black Caribbean and African minority group admissions were significantly more likely to be a longer (>28 days) than shorter (≤28 days) LOS, White British admissions demonstrated the opposite association. After adjusting for demographic, clinical, and behavioral factors, the multivariate logistic regression only partially explained the association between Black Caribbean and African admissions and longer LOS compared to White British admissions. The regression model explained approximately 18% of the observed variance in LOS. ConclusionsThese findings indicate that additional variables, such as treatment, system related, and discrimination-based factors, should be examined to better understand the complex relationship between BME groups and LOS in order to improve the experience and outcomes of these vulnerable psychiatric populations.