Assessing a financial incentive for reducing length of stay of psychiatric inpatients: Implications for financing psychiatric services

Research output: Journal contributionsJournal articlesResearchpeer-review

Authors

QUESTIONS UNDER STUDY: Restricted government budgets are forcing countries to implement more efficient health measures. Unlike in somatic medicine, the process of evaluating payment systems in psychiatry in Switzerland is ongoing. A pilot approach in one psychiatric hospital, here called "new remuneration system (NRS)", was introduced to better control length of stay (LOS) by combining a lump sum with degressive daily rates. This is a first evaluation of the NRS in terms of a reduction of the LOS, and the prevention of early readmissions by analysing meaningful outcome categories. METHODS: The total sample consisted of N = 66,626 psychiatric inpatient episodes and a subsample of N = 60,847. Data were collected from the hospital using the NRS and three comparison hospitals in the Canton of Zurich. The observation period covered 2005 to 2011, the years before and after the implementation of the NRS in 2009. To examine the outcome categories, general logistic models were used. RESULTS: The median LOS at all four hospitals was 21 days (IQR: 46-8). In the NRS-hospital, there was a significantly higher proportion of 6 to10-day stays after 2009, indicating an influence of the lumpsum measure. At the same time, data revealed a somewhat lower proportion of readmissions within 30 days in the NRS-hospital. In general, effect sizes were small. CONCLUSIONS: Within the observation period of three years since 2009, the NRS had a small influence on LOS and early readmissions. The stability of effects needs to be monitored. More sophisticated modellings of the NRS might lead to further insights.

Original languageEnglish
Article numberw13991
JournalSwiss Medical Weekly
Volume144
Number of pages10
ISSN1424-7860
DOIs
Publication statusPublished - 07.08.2014

    Research areas

  • Psychology - Early readmissions, Inpatient psychiatry, Length of stay, Remuneration system

Documents

DOI

Recently viewed

Researchers

  1. André Hajek

Publications

  1. OBI
  2. Das Spiel und seine Grenzen
  3. Die Ruhe selbst
  4. Klimaschutz als intertemporaler Freiheitsschutz
  5. Grußwort, Einführung, Lageplan
  6. Migrationsbewusstsein empirisch
  7. LGVT
  8. Vom Normalstaat zum Ausnahmestaat
  9. Bildung für nachhaltige Entwicklung zum Thema „Wasser“
  10. 'Think Big' or 'Small is Beautiful'?
  11. Integrating corporate sustainability assessment, management accounting, control, and reporting
  12. Das Unwort erklärt die Untat
  13. Overcoming the crisis
  14. Migrantinnen in den Medien
  15. Flüchtlinge, Staatenlose, Überflüssige
  16. Drawing a Picture of Citizen Entrepreneurship
  17. A sticky affair
  18. Nonadherence in outpatient thrombosis prophylaxis with low molecular weight heparins after major orthopaedic surgery
  19. Corruptive Patterns of Patronage in South East Europe by Plamen K. Georgiev
  20. Soziale Bedeutung von Frauen
  21. International Workshop (2019): "The LOSC 25 Years After its Entry into Force: Between Comprehensiveness and Exceptionalism”
  22. § 45 Reinhaltung von Küstengewässern
  23. Empowering Communities Through Citizen Entrepreneurship
  24. Modernization and postmodernization - Cultural, economic and political change in 43 societies
  25. Do works councils inhibit investment?
  26. Qualifizierung und Motivation von Studierenden und Hochschulabsolventen für eine Existenzgründung - Curricularmaterial und Dozentenleitfaden
  27. Symbolische Räume kultureller Diversität
  28. The Man from Bangkok
  29. Wanders, Monika/Preedy, Ingrid/Klippel, Friederike: The Rescue. Hueber, 2006.
  30. Intrinsic human elimination half-lives of polychlorinated biphenyls derived from the temporal evolution of cross-sectional biomonitoring data from the United Kingdom
  31. Was heisst Freundschaft?
  32. Der MBA "Sustainament"
  33. Linking Cap-and-Trade Systems and Green Finance
  34. Mit den Simpsons über das Fernsehen nachdenken