Zusammenfassung
Aim: Currently, financial sponsors and Government officials of the relevant ministries responsible for the German health care system request comparative length-of-stay figures in hospitals as indicators of efficacy of inpatient treatment. In psychiatry such comparisons are considered doubtful because of the heterogeneity of patients in different hospitals. This study compares the length of stay ...
Zusammenfassung
Aim: Currently, financial sponsors and Government officials of the relevant ministries responsible for the German health care system request comparative length-of-stay figures in hospitals as indicators of efficacy of inpatient treatment. In psychiatry such comparisons are considered doubtful because of the heterogeneity of patients in different hospitals. This study compares the length of stay in eight German psychiatric hospitals accounting for individual as well as organisational characteristics. Methods: Sample: 27,792 patient records according to the DGPPN-BADO (the standardized psychiatric assessment and discharge battery in Germany) from eight hospitals with a total of 135 wards. Statistical Analysis: Variance components modelling with random effects using three levels (patients, wards, hospitals). Results: After adjustment for patient and organisational characteristics, there were no significant differences in the average length of stay between the eight hospitals. Conclusions: Hospital comparisons of quality of care require a multilevel approach. Based on our results further comparisons and implementation of quality improvements in inpatient psychiatry should focus on the ward level.
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