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Abstract
Introduction The psychiatric care paradigm has shifted towards community-centered models. Yet, prolonged hospitalizations are still a reality, with debated impact at healthcare systems and patients. Objectives This work aims to describe prolonged hospitalizations in acute psychiatric wards through patients’ sociodemographic and clinical data. Methods We analyzed a national hospitalization database that contained all hospitalization episodes registered in Portuguese public hospitals from 2008 to 2015. All episodes with a primary diagnosis of mental disorder defined as ICD-9-CM codes 290.x-319.x were included. Prolonged hospitalizations were defined as having a LoS ≥ P97.5; LOS ≥180 days or LOS ≥1 year. Age, sex, lengh of stay, in-hospital mortality were analysed. Results The LoS ≥ P97.5(≥62 days) group comprised 3911 hospitalizations (2.3% of all psychiatric hospitalizations) and 1755 patients. The median LOS was 81 days and the mean age was 51 years. Sex was equally distributed, though a higher frequency of male patients was found on the ≥180 days (n=364) and ≥ 1 year (n=121) groups. Psychotic disorders were the main diagnosis at discharge (n= 1769, 45.2%), followed by mood disorders (n=1057, 27.0%) and dementia (n=451, 11.5%). In-hospital mortality increased in the higher LoS groups (1.1%; 4.4%; 9.1%, respectively). Conclusions Overall, middle aged patients with psychotic disorders represent most of the prolonged hospitalizations occurring in acute psychiatric wards. Community-based programs require further development to meet the existing needs. Disclosure No significant relationships.
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1 Department Of Psychiatry And Mental Health, Centro Hospitalar de Vila Nova de Gaia e Espinho, Vila Nova de Gaia, Portugal
2 Cintesis – Center For Health Technology And Services Research, Faculty of Medicine, University of Porto, Porto, Portugal; Department Of Psychiatry And Mental Health, Centro Hospitalar do Tâmega e Sousa, Penafiel, Portugal, Penafiel, Portugal; Department Of Community, Information And Health Decision Sciences (medcids), Faculty of Medicine, University of Porto, Porto, Portugal, Porto, Portugal
3 Department Of Psychiatry And Mental Health, Centro Hospitalar do Tâmega e Sousa, Penafiel, Portugal, Penafiel, Portugal
4 Cintesis – Center For Health Technology And Services Research, Faculty of Medicine, University of Porto, Porto, Portugal; Department Of Community, Information And Health Decision Sciences (medcids), Faculty of Medicine, University of Porto, Porto, Portugal, Porto, Portugal