Background: Research on factors contributing to a patient’s length of stay on
youth psychiatric inpatient units is relatively scarce and increasingly dated given changes in
Objective: Hence, the current exploratory study attempts to take a step at identifying
variables that are associated with length of stay for youth on an inpatient psychiatric unit in
order to generate hypotheses for future larger-scale multisite research.
Method: A chart review was conducted on consecutive admissions to an academic medical
center youth psychiatric inpatient service from September 2011 to June 2014. Analyses are
for 1,201 consecutive admissions (M age = 13.37, SD = 2.79), who were predominantly
African American (54.0%) and female (58.3%).
Results: Significant variables were entered into a hierarchical linear regression organized by
variable category (i.e., patient characteristics, diagnostic/disease related, treatment-related
characteristics, clinical caregiver characteristics, and characteristics or properties of the
healthcare system). The final model accounted of 23% of the variance. Significant variables
included insurance status, psychotic disorder, adjustment disorder, receiving pro re nata
(PRN) medication for agitation during admission, being on a standing antipsychotic, change
in attending from intake to discharge, presence of certain attendings during admission, and
discharge to day hospital program or residential treatment center.
Conclusion: These variables provide provisional information suggesting that factors from
multiple categories are related to length of stay including patient characteristics, diagnosis,
treatment-related, clinical caregiver, and healthcare system. It is critical to take into account
factors both internal and external to the child when developing an understanding of length of
youth psychiatric hospitalization.