This proposal investigates the national information base relative to psychiatric inpatient episodes occurring in general hospitals without psychiatric units. NIMH periodically compiles information on inpatient episodes in non-federal, short-stay (i.e., general) hospitals with psychiatric units. The annual National Hospital Discharge Survey (NHDS), conducted by the NCHS, is a survey of all general hospitals, but includes approximately 10,000 psychiatric inpatient episodes. By subtracting NIMH figures from NCHS figures, the number of psychiatric episodes taking place in general hospitals without units is roughly estimated to be 1.2 million, or approximately 40% of all psychiatric episodes in the U.S. In recent years, the total psychiatric episodes in general hospital psychiatric units has been relatively constant. We propose to derive and investigate national figures regarding psychiatric inpatients in general hospitals without units. NCHS has agreed to provide us with their national data tapes for 1971, 1975, and 1981, three years for which NIMH survey data also exists. The NCHS data base will have to be separated into samples of discharges from hospitals with and without psychiatric units. Also, discharges from hospitals affiliated with CMHCs and from hospitals with substance abuse units will be isolated and analyzed separately. This method allows detailed investigation of: 1) a more refined analysis of all general hospitals (beyond the data already reported nationally; 2) comparative characteristics of inpatient episodes in hospitals with and without units; 3) two independently derived samples of hospitals with psychiatric units (NIMH and the derived NCHS sub-sample); 4) hospitals with separate chemical dependency units and those with no separate units; 5) residual cases in hospitals without affiliation with CHMCs, and without psychiatric units or chemical dependency units. The various samples will be compared on those variables contained in NIMH and NCHS data bases: expected source of payment, length of stay, age, sex, race, marital status, primary diagnosis, and the ownership or control of the hospital. Multi-dimensional statistical interactions are of special interest.
Kiesler, C A; Sibulkin, A E; Morton, T L et al. (1991) Characteristics of psychiatric discharges from nonfederal, short-term specialty hospitals and general hospitals with and without psychiatric and chemical dependency units: the Hospital Discharge Survey data. Health Serv Res 25:881-906 |
Kiesler, C A; Simpkins, C; Morton, T (1990) Predicting length of hospital stay for psychiatric inpatients. Hosp Community Psychiatry 41:149-54 |