The Association Between Decreasing Length of Stay and Readmission Rate on a Psychogeriatric Unit

OBJECTIVE: This study investigated whether there was an association between decreasing length of stay and readmission rate on a psychogeriatric unit. METHODS: Discharge summaries were reviewed for all 1,099 admissions to a university hospital psychogeriatric unit from January 1993 through December 1997. Data were collected for all 77 patients who were readmitted within 30 days of a previous discharge and for an equal number of randomly selected patients who were not readmitted. Data included length of stay, diagnosis, disposition, and demographic information. RESULTS: Mean length of stay decreased significantly over the five-year study period for patients who were readmitted and for those who were not readmitted. The mean length of stay for the index admission of readmitted patients decreased from 33.6 days to 9.5 days. The mean length of stay of patients who were not readmitted decreased from 27.5 days to 12.7 days. Over the same period, the readmission rate doubled, rising from 5.3 percent (seven patients) to 10.8 percent (30 patients), and the proportion of patients who were discharged to the geriatric day hospital increased significantly. CONCLUSIONS: Although it is difficult to demonstrate causality, these findings indicate a temporal association between decreasing length of stay and rate of readmission to a university hospital psychogeriatric unit.