Using daily monitoring of psychiatric symptoms to evaluate hospital length of stay

Abstract

BackgroundRoutine symptom monitoring and feedback improves out-patient outcomes, but the feasibility of its use to inform decisions about discharge from in-patient care has not been explored.AimsTo examine the potential value to clinical decision-making of monitoring symptoms during psychiatric in-patient hospitalisation.MethodA total of 1102 in-patients in a private psychiatric hospital, primarily with affective and neurotic disorders, rated daily distress levels throughout their hospital stay. The trajectories of patients who had, and had not, met a criterion of clinically significant improvement were examined.ResultsTwo-thirds of patients (n=604) met the clinically significant improvement criterion at discharge, and three-quarters (n=867) met the criterion earlier during their hospital stay. After meeting the criterion, the majority (73.2%) showed stable symptoms across the remainder of their hospital stay, and both classes showed substantially lower symptoms than at admission.ConclusionsMonitoring of progress towards this criterion provides additional information regarding significant treatment response that could inform clinical decisions around discharge readiness.