Transfer of care between physician teams does not affect length of stay or symptomatic improvement in hospitalized psychiatric patients

Abstract 

To determine if the length of stay, discharge against medical advice (AMA) or psychiatric symptom severity differs when patients are treated by a single team of physicians versus transfer to a second team all cases (N=1304) admitted to the high intensity psychiatric unit then transferred to a lower intensity unit of a single hospital over 39 months were reviewed. A modified version of the Psychiatric Symptom Assessment Scale (PSAS) was completed on admission and discharge. Statistical analyses including linear and logistic regressions were performed. We found that the length of stay (mean ±SD) was 18.7±10.9 days for transferred patients (N=871) and 18.3± 10.6 days for those cared for by only one team (P=.507). Discharge PSAS scores (11.8±9.4 for transferred patients and 14.2±10.4 for those who kept their physicians), were not different between groups after adjustment for severity on admission. Discharges against medical advice were not different between the groups (P=.207). Although the previous internal medicine literature and single psychiatric study describe a longer length of stay for those patients transferred between physicians, this study shows no differences in terms of length of stay, severity on discharge or AMA discharge rate.

Keywords:  Transfer of care, Length of stay, Continuity of care, Psychiatric hospitalization