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