Association of high psychiatrist staffing with prolonged hospitalization, follow-up visits, and readmission in acute psychiatric units: a retrospective cohort study using a nationwide claims database

Yasuyuki Okumura,1 Naoya Sugiyama,2 Toshie Noda,3 Nobuo Sakata1 1Research Department, Institute for Health Economics and Policy, Association for Health Economics Research and Social Insurance and Welfare, Tokyo, Japan; 2Numazu Chuo Hospital, Fukkokai Foundation, Shizuoka, Japan; 3Atami Chuo Clinic,...

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Autores principales:	Okumura Y, Sugiyama N, Noda T, Sakata N
Formato:	article
Lenguaje:	EN
Publicado:	Dove Medical Press 2018
Materias:	readmission rate length of stay quality of care physician ratio workforce psychiatrist staffing. Neurosciences. Biological psychiatry. Neuropsychiatry RC321-571 Neurology. Diseases of the nervous system RC346-429
Acceso en línea:	https://doaj.org/article/e63eaf878c9547afb32defbaedd5cafc
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spelling	oai:doaj.org-article:e63eaf878c9547afb32defbaedd5cafc2021-12-02T01:32:58ZAssociation of high psychiatrist staffing with prolonged hospitalization, follow-up visits, and readmission in acute psychiatric units: a retrospective cohort study using a nationwide claims database1178-2021https://doaj.org/article/e63eaf878c9547afb32defbaedd5cafc2018-03-01T00:00:00Zhttps://www.dovepress.com/association-of-high-psychiatrist-staffing-with-prolonged-hospitalizati-peer-reviewed-article-NDThttps://doaj.org/toc/1178-2021Yasuyuki Okumura,1 Naoya Sugiyama,2 Toshie Noda,3 Nobuo Sakata1 1Research Department, Institute for Health Economics and Policy, Association for Health Economics Research and Social Insurance and Welfare, Tokyo, Japan; 2Numazu Chuo Hospital, Fukkokai Foundation, Shizuoka, Japan; 3Atami Chuo Clinic, Fukkokai Foundation, Shizuoka, Japan Background: The effects of psychiatrist staffing are unclear. The aim of this study was to assess the association of high psychiatrist staffing with prolonged hospitalization, follow-up visits, and readmission in acute psychiatric units.Methods: A retrospective cohort study was conducted using the National Database of Health Insurance Claim Information and Specified Medical Checkups. Patients newly admitted to acute psychiatric units between October 2014 and September 2015 were followed up until September 2016. The primary exposure was a patient-to-psychiatrist ratio of 16:1 (high-staffing units) vs 48:1 (low-staffing units). Outcomes were prolonged hospitalization of >90 days, number of follow-up psychiatric visits within 90 days after discharge, and psychiatric readmission within 90 days after discharge. Incidence rate ratios (IRRs) and their 95% confidence intervals (CIs) were estimated by using generalized estimating equations, adjusting for potential covariates.Results: Among the 24,678 newly admitted patients at 190 hospitals, 13,138 patients (53.2%) were admitted to high-staffing units in 92 hospitals. After adjustment, high-staffing units were associated with a lower risk of prolonged hospitalization (incidence rate, 16.9 vs 21.3%; IRR, 0.79 [95% CI, 0.70, 0.89]), higher number of follow-up visits (incidence rate of ≥7 visits, 16.9 vs 13.4%; IRR, 1.06 [95% CI, 1.01, 1.12]), and lower risk of readmission (incidence rate, 13.0 vs 14.4%; IRR, 0.90 [95% CI, 0.82, 0.99]).Conclusion: High-staffing units are associated with a reduced risk of prolonged hospitalization and readmission and an increased number of follow-up visits. Further research is needed to improve the generalizability of these findings and establish the optimal level of staffing. Keywords: readmission rate, length of stay, quality of care, physician ratio, workforce, psychiatrist staffing Okumura YSugiyama NNoda TSakata NDove Medical Pressarticlereadmission ratelength of stayquality of carephysician ratioworkforcepsychiatrist staffing.Neurosciences. Biological psychiatry. NeuropsychiatryRC321-571Neurology. Diseases of the nervous systemRC346-429ENNeuropsychiatric Disease and Treatment, Vol Volume 14, Pp 893-902 (2018)
institution	DOAJ
collection	DOAJ
language	EN
topic	readmission rate length of stay quality of care physician ratio workforce psychiatrist staffing. Neurosciences. Biological psychiatry. Neuropsychiatry RC321-571 Neurology. Diseases of the nervous system RC346-429
spellingShingle	readmission rate length of stay quality of care physician ratio workforce psychiatrist staffing. Neurosciences. Biological psychiatry. Neuropsychiatry RC321-571 Neurology. Diseases of the nervous system RC346-429 Okumura Y Sugiyama N Noda T Sakata N Association of high psychiatrist staffing with prolonged hospitalization, follow-up visits, and readmission in acute psychiatric units: a retrospective cohort study using a nationwide claims database
description	Yasuyuki Okumura,1 Naoya Sugiyama,2 Toshie Noda,3 Nobuo Sakata1 1Research Department, Institute for Health Economics and Policy, Association for Health Economics Research and Social Insurance and Welfare, Tokyo, Japan; 2Numazu Chuo Hospital, Fukkokai Foundation, Shizuoka, Japan; 3Atami Chuo Clinic, Fukkokai Foundation, Shizuoka, Japan Background: The effects of psychiatrist staffing are unclear. The aim of this study was to assess the association of high psychiatrist staffing with prolonged hospitalization, follow-up visits, and readmission in acute psychiatric units.Methods: A retrospective cohort study was conducted using the National Database of Health Insurance Claim Information and Specified Medical Checkups. Patients newly admitted to acute psychiatric units between October 2014 and September 2015 were followed up until September 2016. The primary exposure was a patient-to-psychiatrist ratio of 16:1 (high-staffing units) vs 48:1 (low-staffing units). Outcomes were prolonged hospitalization of >90 days, number of follow-up psychiatric visits within 90 days after discharge, and psychiatric readmission within 90 days after discharge. Incidence rate ratios (IRRs) and their 95% confidence intervals (CIs) were estimated by using generalized estimating equations, adjusting for potential covariates.Results: Among the 24,678 newly admitted patients at 190 hospitals, 13,138 patients (53.2%) were admitted to high-staffing units in 92 hospitals. After adjustment, high-staffing units were associated with a lower risk of prolonged hospitalization (incidence rate, 16.9 vs 21.3%; IRR, 0.79 [95% CI, 0.70, 0.89]), higher number of follow-up visits (incidence rate of ≥7 visits, 16.9 vs 13.4%; IRR, 1.06 [95% CI, 1.01, 1.12]), and lower risk of readmission (incidence rate, 13.0 vs 14.4%; IRR, 0.90 [95% CI, 0.82, 0.99]).Conclusion: High-staffing units are associated with a reduced risk of prolonged hospitalization and readmission and an increased number of follow-up visits. Further research is needed to improve the generalizability of these findings and establish the optimal level of staffing. Keywords: readmission rate, length of stay, quality of care, physician ratio, workforce, psychiatrist staffing
format	article
author	Okumura Y Sugiyama N Noda T Sakata N
author_facet	Okumura Y Sugiyama N Noda T Sakata N
author_sort	Okumura Y
title	Association of high psychiatrist staffing with prolonged hospitalization, follow-up visits, and readmission in acute psychiatric units: a retrospective cohort study using a nationwide claims database
title_short	Association of high psychiatrist staffing with prolonged hospitalization, follow-up visits, and readmission in acute psychiatric units: a retrospective cohort study using a nationwide claims database
title_full	Association of high psychiatrist staffing with prolonged hospitalization, follow-up visits, and readmission in acute psychiatric units: a retrospective cohort study using a nationwide claims database
title_fullStr	Association of high psychiatrist staffing with prolonged hospitalization, follow-up visits, and readmission in acute psychiatric units: a retrospective cohort study using a nationwide claims database
title_full_unstemmed	Association of high psychiatrist staffing with prolonged hospitalization, follow-up visits, and readmission in acute psychiatric units: a retrospective cohort study using a nationwide claims database
title_sort	association of high psychiatrist staffing with prolonged hospitalization, follow-up visits, and readmission in acute psychiatric units: a retrospective cohort study using a nationwide claims database
publisher	Dove Medical Press
publishDate	2018
url	https://doaj.org/article/e63eaf878c9547afb32defbaedd5cafc
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Association of high psychiatrist staffing with prolonged hospitalization, follow-up visits, and readmission in acute psychiatric units: a retrospective cohort study using a nationwide claims database

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