Associations of homelessness and residential mobility with length of stay after acute psychiatric admission

2.50
Hdl Handle:
http://hdl.handle.net/10147/253669
Title:
Associations of homelessness and residential mobility with length of stay after acute psychiatric admission
Authors:
Tulloch, Alex D; Khondoker, Mizanur R; Fearon, Paul; David, Anthony S
Citation:
BMC Psychiatry. 2012 Aug 21;12(1):121
Issue Date:
21-Aug-2012
URI:
http://dx.doi.org/10.1186/1471-244X-12-121; http://hdl.handle.net/10147/253669
Abstract:
Abstract Background A small number of patient-level variables have replicated associations with the length of stay (LOS) of psychiatric inpatients. Although need for housing has often been identified as a cause of delayed discharge, there has been little research into the associations between LOS and homelessness and residential mobility (moving to a new home), or the magnitude of these associations compared to other exposures. Methods Cross-sectional study of 4885 acute psychiatric admissions to a mental health NHS Trust serving four South London boroughs. Data were taken from a comprehensive repository of anonymised electronic patient records. Analysis was performed using log-linear regression. Results Residential mobility was associated with a 99% increase in LOS and homelessness with a 45% increase. Schizophrenia, other psychosis, the longest recent admission, residential mobility, and some items on the Health of the Nation Outcome Scales (HoNOS), especially ADL impairment, were also associated with increased LOS. Informal admission, drug and alcohol or other non-psychotic diagnosis and a high HoNOS self-harm score reduced LOS. Including residential mobility in the regression model produced the same increase in the variance explained as including diagnosis; only legal status was a stronger predictor. Conclusions Homelessness and, especially, residential mobility account for a significant part of variation in LOS despite affecting a minority of psychiatric inpatients; for these people, the effect on LOS is marked. Appropriate policy responses may include attempts to avert the loss of housing in association with admission, efforts to increase housing supply and the speed at which it is made available, and reforms of payment systems to encourage this.
Item Type:
Journal Article

Full metadata record

DC FieldValue Language
dc.contributor.authorTulloch, Alex D-
dc.contributor.authorKhondoker, Mizanur R-
dc.contributor.authorFearon, Paul-
dc.contributor.authorDavid, Anthony S-
dc.date.accessioned2012-11-28T12:42:30Z-
dc.date.available2012-11-28T12:42:30Z-
dc.date.issued2012-08-21-
dc.identifier.citationBMC Psychiatry. 2012 Aug 21;12(1):121-
dc.identifier.urihttp://dx.doi.org/10.1186/1471-244X-12-121-
dc.identifier.urihttp://hdl.handle.net/10147/253669-
dc.description.abstractAbstract Background A small number of patient-level variables have replicated associations with the length of stay (LOS) of psychiatric inpatients. Although need for housing has often been identified as a cause of delayed discharge, there has been little research into the associations between LOS and homelessness and residential mobility (moving to a new home), or the magnitude of these associations compared to other exposures. Methods Cross-sectional study of 4885 acute psychiatric admissions to a mental health NHS Trust serving four South London boroughs. Data were taken from a comprehensive repository of anonymised electronic patient records. Analysis was performed using log-linear regression. Results Residential mobility was associated with a 99% increase in LOS and homelessness with a 45% increase. Schizophrenia, other psychosis, the longest recent admission, residential mobility, and some items on the Health of the Nation Outcome Scales (HoNOS), especially ADL impairment, were also associated with increased LOS. Informal admission, drug and alcohol or other non-psychotic diagnosis and a high HoNOS self-harm score reduced LOS. Including residential mobility in the regression model produced the same increase in the variance explained as including diagnosis; only legal status was a stronger predictor. Conclusions Homelessness and, especially, residential mobility account for a significant part of variation in LOS despite affecting a minority of psychiatric inpatients; for these people, the effect on LOS is marked. Appropriate policy responses may include attempts to avert the loss of housing in association with admission, efforts to increase housing supply and the speed at which it is made available, and reforms of payment systems to encourage this.-
dc.titleAssociations of homelessness and residential mobility with length of stay after acute psychiatric admission-
dc.typeJournal Article-
dc.language.rfc3066en-
dc.rights.holderAlex D Tulloch et al.; licensee BioMed Central Ltd.-
dc.description.versionPeer Reviewed-
dc.date.updated2012-11-23T20:07:21Z-
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