Sunday, April 14, 2024

Exploring Determinants of Hospital Stay Duration in Forensic Psychiatry: Insights from a Systematic Review

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Forensic psychiatry, often associated with lengthy admissions and high care costs, has little known about the factors that influence the length of stay (LOS) in hospitals. This is despite the absence of any systematic review that has synthesized the available data. The aim is to identify the factors that influence LOS in forensic psychiatry hospitals, which can potentially inform care and interventions that may reduce the length of admissions.

A systematic review was conducted, searching major databases such as PubMed, EMBASE, and PsycInfo, covering all data from inception until May 2022. The review included observational studies conducted in forensic hospitals examining associations between variables of interest and LOS. The Newcastle-Ottawa Scale was utilized for quality appraisal. The heterogeneity of information ruled out the possibility of conducting a meta-analysis, and a quantitative measure for assessing the strength of evidence was developed and reported instead.

Forensic Psychiatry

Identifying Key Influences on Hospital Stay Length in Forensic Psychiatry

Out of 1606 citations, 28 studies met the inclusion criteria. A detailed quantitative synthesis was carried out using robust criteria. Factors such as having committed homicide or attempted homicide, having a criminal legal status with restrictions, and a diagnosis of schizophrenia-spectrum disorders were found to be associated with a longer LOS. Conversely, higher Global Assessment of Functioning (GAF) scores were associated with a shorter LOS.

It is concluded that high-quality research examining factors associated with LOS in forensic psychiatry is lacking, and the studies are heterogeneous. No modifiable characteristics were identified, and thus, no practice recommendations were made. However, it was emphasized that understanding the factors associated with longer admissions is increasingly necessary to inform care and facilitate successful reintegration and rehabilitation.

This study provides recommendations for future research to further explore the factors influencing LOS in forensic psychiatry hospitals and how these can be addressed to improve patient outcomes and care efficiency.


Original article: Factors influencing the length of stay in forensic psychiatric settings: a systematic review. BMC Health Serv Res. 2024 Mar 29;24(1):400. doi: 10.1186/s12913-024-10863-x. PMID: 38553762; PMCID: PMC10981349.

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