Factors predicting length of stay in an adolescent psychiatric unit: A retrospective study

Background: In a context of increasing needs for child and adolescent psychiatry, psychiatric inpatient units are more and more solicited. We aim here to determine the factors predicting the length of stay (LOS) in an adolescent psychiatric unit. Methods: We conducted a monocentric retrospective chart-review study based on all medical charts of adolescents who had been hospitalized in two full-time hospitalization units for adolescents in a university-based child psychiatry service (n = 191). Results: The mean LOS in this sample was 96 days (SD = 101, min = 1, max = 600, median 67). In multivariate analyses, the variables statistically associated with LOS were: a diagnosis of schizophrenia, an eating disorder, presence of suicidal ideation, a low score on the Children's Global Assessment of Functioning (C-GAF) scale at admission, having an educational measure, and being addressed at discharge to a part-time ambulatory care center. This model predicted around 40% of the LOS variance. Conclusion: The association between clinical and functional factors and the LOS are independent. The contribution of other factors (e.g., social factors and due to the health care system) raises questions about the objectives of inpatient treatment (i.e., crisis interventions, or developing the outpatient health care project via collaborative works with other professions).