Question: In older adult psychiatric services, what factors or interventions contribute to reducing the average length of stay/admission?



The studies included in this evidence summary do not provide sufficient evidence to support the effectiveness of any intervention in reducing the average length of hospital stay or admissions in older adult psychiatric services. None of the three systematic reviews identified directly addressed the question specified for this evidence summary; all three included only small numbers of studies, which were considered to be relevant, or partially relevant. There was no evidence on the effectiveness of discharge planning in reducing length of hospital stay and some evidence, from partially relevant populations, for small decrease in the number of re-admissions. Evidence on the effectiveness of care pathways for reducing length of hospital stay was sparse and contradictory. One small, poor quality randomised controlled trial indicated that home treatment of depression in elderly people who are living independently, may be associated with a reduction in the frequency and duration of in-patient admissions, compared with usual care, however, it should be noted that 90% of the participants in this study were female and 78% were living alone; results may not be generalisable to the all elderly depressed patients.

Further research is needed on interventions to reduce the number and duration of hospital admissions in setting specific to older adult psychiatric services.