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Patient Requests for Discharge from Voluntary Psychiatric Hospitalization: a Chart Review
The purpose of this study was to examine the rate of 72-hour letters (written requests for discharge, with 72 hours indicating the time the hospital has to discharge or seek retention) placed by voluntary psychiatric inpatients at a New York City hospital and determine whether there are factors cont...
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| Published in: | Psychiatric quarterly 2019-12, Vol.90 (4), p.849-859 |
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| Main Authors: | , , , , , |
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| container_end_page | 859 |
| container_issue | 4 |
| container_start_page | 849 |
| container_title | Psychiatric quarterly |
| container_volume | 90 |
| creator | Garakani, Amir Appel, Jacob M. Aloysi, Amy S. Martinez, Jose M. Larkin, Kaitlyn Buono, Frank D. |
| description | The purpose of this study was to examine the rate of 72-hour letters (written requests for discharge, with 72 hours indicating the time the hospital has to discharge or seek retention) placed by voluntary psychiatric inpatients at a New York City hospital and determine whether there are factors contributing to the rates of discharge requests. Charts from all voluntary psychiatric hospitalizations during the calendar year 2007 were retrospectively reviewed. Included were all single voluntary admissions by adults (age 18 years and older) to the hospital. A confirmatory factor analysis (CFA) was conducted with the following factors: urine toxicology, cigarette use on admission, suicidal ideation upon presentation, employment, past inpatient psychiatric admission, and admission day. A linear regression was used to evaluate the relationship between discharge requests and these factors. Of the total sample (
N
= 581), 119 (20.5%) patients submitted 72-hour letters. The stepwise linear regression analysis confirmed a positive relationship between letter placement and admission day (M = 3.5, SD = 1.7), unemployment (M = 4.7, SD = 2.1), suicidal ideation (M = .5, SD = .5), positive urine toxicology (M = .47, SD = .5), previous psychiatric hospitalization (M = .7, SD = .5) and cigarette usage (M = .5, SD.5) R
2
= .043, (6, 461) = 3.42,
p
= .003). These specific variables accounted for 55.6% of likelihood of a patient submitting a 72-hour letter. Several factors, related to substance and tobacco use, employment, and recurrent use of inpatient services, likely contribute to requests for early discharge. Addressing these factors may help improve inpatient care, reduce costs and improve patient outcomes in the long term. |
| doi_str_mv | 10.1007/s11126-019-09671-y |
| format | article |
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N
= 581), 119 (20.5%) patients submitted 72-hour letters. The stepwise linear regression analysis confirmed a positive relationship between letter placement and admission day (M = 3.5, SD = 1.7), unemployment (M = 4.7, SD = 2.1), suicidal ideation (M = .5, SD = .5), positive urine toxicology (M = .47, SD = .5), previous psychiatric hospitalization (M = .7, SD = .5) and cigarette usage (M = .5, SD.5) R
2
= .043, (6, 461) = 3.42,
p
= .003). These specific variables accounted for 55.6% of likelihood of a patient submitting a 72-hour letter. Several factors, related to substance and tobacco use, employment, and recurrent use of inpatient services, likely contribute to requests for early discharge. Addressing these factors may help improve inpatient care, reduce costs and improve patient outcomes in the long term.</description><identifier>ISSN: 0033-2720</identifier><identifier>EISSN: 1573-6709</identifier><identifier>DOI: 10.1007/s11126-019-09671-y</identifier><identifier>PMID: 31468251</identifier><language>eng</language><publisher>New York: Springer US</publisher><subject>Chart reviews ; Clinical outcomes ; Confirmatory factor analysis ; Early discharge ; Employment ; Factor analysis ; Health care expenditures ; Hospitalization ; Inpatient care ; Medicine ; Medicine & Public Health ; Mental disorders ; Original Paper ; Patient admissions ; Psychiatric hospitals ; Psychiatry ; Public Health ; Recurrent ; Regression analysis ; Sociology ; Suicidal ideation ; Suicide ; Tobacco ; Toxicology ; Unemployment ; Urine ; Voluntary</subject><ispartof>Psychiatric quarterly, 2019-12, Vol.90 (4), p.849-859</ispartof><rights>Springer Science+Business Media, LLC, part of Springer Nature 2019</rights><rights>Psychiatric Quarterly is a copyright of Springer, (2019). All Rights Reserved.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c375t-a9900131679f21d33ea03601877a15dcb4f9b4b8e80b05e9bd578797301bea4b3</citedby><cites>FETCH-LOGICAL-c375t-a9900131679f21d33ea03601877a15dcb4f9b4b8e80b05e9bd578797301bea4b3</cites><orcidid>0000-0002-9749-8372</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://www.proquest.com/docview/2282307774/fulltextPDF?pq-origsite=primo$$EPDF$$P50$$Gproquest$$H</linktopdf><linktohtml>$$Uhttps://www.proquest.com/docview/2282307774?pq-origsite=primo$$EHTML$$P50$$Gproquest$$H</linktohtml><link.rule.ids>315,786,790,12873,21422,21423,27957,27958,31034,33646,34565,43768,44150,74578,74996</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/31468251$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Garakani, Amir</creatorcontrib><creatorcontrib>Appel, Jacob M.</creatorcontrib><creatorcontrib>Aloysi, Amy S.</creatorcontrib><creatorcontrib>Martinez, Jose M.</creatorcontrib><creatorcontrib>Larkin, Kaitlyn</creatorcontrib><creatorcontrib>Buono, Frank D.</creatorcontrib><title>Patient Requests for Discharge from Voluntary Psychiatric Hospitalization: a Chart Review</title><title>Psychiatric quarterly</title><addtitle>Psychiatr Q</addtitle><addtitle>Psychiatr Q</addtitle><description>The purpose of this study was to examine the rate of 72-hour letters (written requests for discharge, with 72 hours indicating the time the hospital has to discharge or seek retention) placed by voluntary psychiatric inpatients at a New York City hospital and determine whether there are factors contributing to the rates of discharge requests. Charts from all voluntary psychiatric hospitalizations during the calendar year 2007 were retrospectively reviewed. Included were all single voluntary admissions by adults (age 18 years and older) to the hospital. A confirmatory factor analysis (CFA) was conducted with the following factors: urine toxicology, cigarette use on admission, suicidal ideation upon presentation, employment, past inpatient psychiatric admission, and admission day. A linear regression was used to evaluate the relationship between discharge requests and these factors. Of the total sample (
N
= 581), 119 (20.5%) patients submitted 72-hour letters. The stepwise linear regression analysis confirmed a positive relationship between letter placement and admission day (M = 3.5, SD = 1.7), unemployment (M = 4.7, SD = 2.1), suicidal ideation (M = .5, SD = .5), positive urine toxicology (M = .47, SD = .5), previous psychiatric hospitalization (M = .7, SD = .5) and cigarette usage (M = .5, SD.5) R
2
= .043, (6, 461) = 3.42,
p
= .003). These specific variables accounted for 55.6% of likelihood of a patient submitting a 72-hour letter. Several factors, related to substance and tobacco use, employment, and recurrent use of inpatient services, likely contribute to requests for early discharge. Addressing these factors may help improve inpatient care, reduce costs and improve patient outcomes in the long term.</description><subject>Chart reviews</subject><subject>Clinical outcomes</subject><subject>Confirmatory factor analysis</subject><subject>Early discharge</subject><subject>Employment</subject><subject>Factor analysis</subject><subject>Health care expenditures</subject><subject>Hospitalization</subject><subject>Inpatient care</subject><subject>Medicine</subject><subject>Medicine & Public Health</subject><subject>Mental disorders</subject><subject>Original Paper</subject><subject>Patient admissions</subject><subject>Psychiatric hospitals</subject><subject>Psychiatry</subject><subject>Public Health</subject><subject>Recurrent</subject><subject>Regression analysis</subject><subject>Sociology</subject><subject>Suicidal ideation</subject><subject>Suicide</subject><subject>Tobacco</subject><subject>Toxicology</subject><subject>Unemployment</subject><subject>Urine</subject><subject>Voluntary</subject><issn>0033-2720</issn><issn>1573-6709</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2019</creationdate><recordtype>article</recordtype><sourceid>7QJ</sourceid><sourceid>ALSLI</sourceid><sourceid>HEHIP</sourceid><recordid>eNp9kMtOwzAQRS0EoqXwAyyQJdaBGTuJY3aoPIpUiQoBEivLSZ02VZsUOwGFr8dtCuxYeTH3nvEcQk4RLhBAXDpEZHEAKAOQscCg3SN9jAQPYgFyn_QBOA-YYNAjR84tABBjzg5Jj2MYJyzCPnmb6LowZU2fzHtjXO1oXll6U7hsru3M0NxWK_paLZuy1ralE9dm80LXtsjoqHLrotbL4ssjqvKKajr0pQ3qozCfx-Qg10tnTnbvgLzc3T4PR8H48f5heD0OMi6iOtBS-n9xjIXMGU45Nxp4DJgIoTGaZmmYyzRME5NACpGR6TQSiZCCA6ZGhykfkPOOu7bV9gS1qBpb-pWKsYRxEEKEPsW6VGYr56zJ1doWK3-SQlAbm6qzqbxNtbWpWl8626GbdGWmv5UffT7Au4Dzo3Jm7N_uf7DfzL2AOQ</recordid><startdate>20191201</startdate><enddate>20191201</enddate><creator>Garakani, Amir</creator><creator>Appel, Jacob M.</creator><creator>Aloysi, Amy S.</creator><creator>Martinez, Jose M.</creator><creator>Larkin, Kaitlyn</creator><creator>Buono, Frank D.</creator><general>Springer US</general><general>Springer Nature B.V</general><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>0-V</scope><scope>3V.</scope><scope>7QJ</scope><scope>7TK</scope><scope>7X7</scope><scope>7XB</scope><scope>88E</scope><scope>88G</scope><scope>8AO</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>8G5</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>ALSLI</scope><scope>AZQEC</scope><scope>BENPR</scope><scope>CCPQU</scope><scope>DWQXO</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>GNUQQ</scope><scope>GUQSH</scope><scope>HEHIP</scope><scope>K9.</scope><scope>M0S</scope><scope>M1P</scope><scope>M2M</scope><scope>M2O</scope><scope>M2S</scope><scope>MBDVC</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PRINS</scope><scope>PSYQQ</scope><scope>Q9U</scope><orcidid>https://orcid.org/0000-0002-9749-8372</orcidid></search><sort><creationdate>20191201</creationdate><title>Patient Requests for Discharge from Voluntary Psychiatric Hospitalization: a Chart Review</title><author>Garakani, Amir ; Appel, Jacob M. ; Aloysi, Amy S. ; Martinez, Jose M. ; Larkin, Kaitlyn ; Buono, Frank D.</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c375t-a9900131679f21d33ea03601877a15dcb4f9b4b8e80b05e9bd578797301bea4b3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2019</creationdate><topic>Chart reviews</topic><topic>Clinical outcomes</topic><topic>Confirmatory factor analysis</topic><topic>Early discharge</topic><topic>Employment</topic><topic>Factor analysis</topic><topic>Health care expenditures</topic><topic>Hospitalization</topic><topic>Inpatient care</topic><topic>Medicine</topic><topic>Medicine & Public Health</topic><topic>Mental disorders</topic><topic>Original Paper</topic><topic>Patient admissions</topic><topic>Psychiatric hospitals</topic><topic>Psychiatry</topic><topic>Public Health</topic><topic>Recurrent</topic><topic>Regression analysis</topic><topic>Sociology</topic><topic>Suicidal ideation</topic><topic>Suicide</topic><topic>Tobacco</topic><topic>Toxicology</topic><topic>Unemployment</topic><topic>Urine</topic><topic>Voluntary</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Garakani, Amir</creatorcontrib><creatorcontrib>Appel, Jacob M.</creatorcontrib><creatorcontrib>Aloysi, Amy S.</creatorcontrib><creatorcontrib>Martinez, Jose M.</creatorcontrib><creatorcontrib>Larkin, Kaitlyn</creatorcontrib><creatorcontrib>Buono, Frank D.</creatorcontrib><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Social Sciences Premium Collection</collection><collection>ProQuest Central (Corporate)</collection><collection>Applied Social Sciences Index & Abstracts (ASSIA)</collection><collection>Neurosciences Abstracts</collection><collection>Health & Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Medical Database (Alumni Edition)</collection><collection>Psychology Database (Alumni)</collection><collection>ProQuest Pharma Collection</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>Research Library (Alumni Edition)</collection><collection>ProQuest Central (Alumni)</collection><collection>ProQuest Central</collection><collection>Social Science Premium Collection</collection><collection>ProQuest Central Essentials</collection><collection>ProQuest Central</collection><collection>ProQuest One Community College</collection><collection>ProQuest Central Korea</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>ProQuest Central Student</collection><collection>Research Library Prep</collection><collection>Sociology Collection</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>Medical Database</collection><collection>Psychology Database (ProQuest)</collection><collection>Research Library</collection><collection>Sociology Database</collection><collection>Research Library (Corporate)</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>ProQuest Central China</collection><collection>ProQuest One Psychology</collection><collection>ProQuest Central Basic</collection><jtitle>Psychiatric quarterly</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Garakani, Amir</au><au>Appel, Jacob M.</au><au>Aloysi, Amy S.</au><au>Martinez, Jose M.</au><au>Larkin, Kaitlyn</au><au>Buono, Frank D.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Patient Requests for Discharge from Voluntary Psychiatric Hospitalization: a Chart Review</atitle><jtitle>Psychiatric quarterly</jtitle><stitle>Psychiatr Q</stitle><addtitle>Psychiatr Q</addtitle><date>2019-12-01</date><risdate>2019</risdate><volume>90</volume><issue>4</issue><spage>849</spage><epage>859</epage><pages>849-859</pages><issn>0033-2720</issn><eissn>1573-6709</eissn><abstract>The purpose of this study was to examine the rate of 72-hour letters (written requests for discharge, with 72 hours indicating the time the hospital has to discharge or seek retention) placed by voluntary psychiatric inpatients at a New York City hospital and determine whether there are factors contributing to the rates of discharge requests. Charts from all voluntary psychiatric hospitalizations during the calendar year 2007 were retrospectively reviewed. Included were all single voluntary admissions by adults (age 18 years and older) to the hospital. A confirmatory factor analysis (CFA) was conducted with the following factors: urine toxicology, cigarette use on admission, suicidal ideation upon presentation, employment, past inpatient psychiatric admission, and admission day. A linear regression was used to evaluate the relationship between discharge requests and these factors. Of the total sample (
N
= 581), 119 (20.5%) patients submitted 72-hour letters. The stepwise linear regression analysis confirmed a positive relationship between letter placement and admission day (M = 3.5, SD = 1.7), unemployment (M = 4.7, SD = 2.1), suicidal ideation (M = .5, SD = .5), positive urine toxicology (M = .47, SD = .5), previous psychiatric hospitalization (M = .7, SD = .5) and cigarette usage (M = .5, SD.5) R
2
= .043, (6, 461) = 3.42,
p
= .003). These specific variables accounted for 55.6% of likelihood of a patient submitting a 72-hour letter. Several factors, related to substance and tobacco use, employment, and recurrent use of inpatient services, likely contribute to requests for early discharge. Addressing these factors may help improve inpatient care, reduce costs and improve patient outcomes in the long term.</abstract><cop>New York</cop><pub>Springer US</pub><pmid>31468251</pmid><doi>10.1007/s11126-019-09671-y</doi><tpages>11</tpages><orcidid>https://orcid.org/0000-0002-9749-8372</orcidid></addata></record> |
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| ispartof | Psychiatric quarterly, 2019-12, Vol.90 (4), p.849-859 |
| issn | 0033-2720 1573-6709 |
| language | eng |
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| source | Applied Social Sciences Index & Abstracts (ASSIA); Social Science Premium Collection; Sociology Collection; Springer Link |
| subjects | Chart reviews Clinical outcomes Confirmatory factor analysis Early discharge Employment Factor analysis Health care expenditures Hospitalization Inpatient care Medicine Medicine & Public Health Mental disorders Original Paper Patient admissions Psychiatric hospitals Psychiatry Public Health Recurrent Regression analysis Sociology Suicidal ideation Suicide Tobacco Toxicology Unemployment Urine Voluntary |
| title | Patient Requests for Discharge from Voluntary Psychiatric Hospitalization: a Chart Review |
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