Review Article
Onofa Lucky, Sowunmi Oladipo,
Abstract
Introduction: The concept of length of admission among psychiatric patients may be used as an indicator of service efficiency, quality of care and also for planning and distribution of hospital resources. Most studies on length of stay among psychiatric patients in Nigeria were conducted in Psychiatry department of tertiary hospitals with rarity of such studies in psychiatric mono-specialist where we have bulk of in-patients. Aim: This study was undertaken to determine the factors that influence length of admission among patients discharged in a specialist Neuropsychiatric Hospital in Nigeria. Methodology: This was a descriptive retrospective study at the Neuropsychiatric Hospital Aro Abeokuta Ogun State Nigeria. Valid Case notes of 605 patients admitted into the hospital and discharged in 2013(January-December) were reviewed. Data was analysed using SPSS version 21. Results: There were 605 patients with 642 admissions. The majority of the patients were males (59.7%) and mean(SD) age of the sample was 36.3(19.0) years. The median duration of admission was 61.0 days. The factors that significantly(P<0.05) prolonged admission beyond 30 days were; single marital status, unemployment, past psychiatric history, duration of untreated psychosis >6 months, diagnoses of schizophrenia, bipolar affective disorders, schizoaffective disorder and behavioural disorder due to psychoactive use, use of long acting depot preparation, poly-therapy treatment, multiple episodes of illness and admission, and the request of specialised laboratory investigations. Logistic regression analysis showed that independent predictors of prolonged length of stay were duration of untreated psychosis >6 months, a past psychiatric history, diagnosis of bipolar affective disorder, poly-therapy treatment and the request of specialized laboratory investigations. Conclusion: Our study has shown the importance of socioeconomic and clinical factors on LOS and the need for mental health professionals to be familiar with those factors while planning and delivering psychiatric treatment. It is hoped that this study will provide a template that policy makers and the government as a whole can use to improve mental health service in Nigeria.