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Length of stay for inpatient incompetent to stand trial patients: importance of clinical and demographic variables

Published online by Cambridge University Press:  09 June 2020

Charles Broderick Open the ORCID record for Charles Broderick [Opens in a new window] ,
Allen Azizian  and
Katherine Warburton Open the ORCID record for Katherine Warburton [Opens in a new window]
Charles Broderick*
Affiliation:
California Department of State Hospitals, Sacramento, California, USA
Allen Azizian
Affiliation:
California Department of State Hospitals, Sacramento, California, USA Department of Criminology, California State University, Fresno, California, USA
Katherine Warburton
Affiliation:
California Department of State Hospitals, Sacramento, California, USA Department of Psychiatry, University of California Davis, Davis, California, USA
*
*Address correspondence to: Charles Broderick, PhD, California Department of State Hospitals, Clinical Operations Division, 1600 9th Street, Room 400, Sacramento, CA 95814, USA. (Email: charles.broderick@dsh.ca.gov)
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Abstract

Objective

We investigated clinical and demographic variables to better understand their relationship to hospital length of stay for patients involuntarily committed to California state psychiatric hospitals under the state’s incompetent to stand trial (IST) statutes. Additionally, we determined the most important variables in the model that influenced patient length of stay.

Methods

We retrospectively studied all patients admitted as IST to California state psychiatric hospitals during the period January 1, 2010 through June 30, 2018 (N = 20 041). Primary diagnosis, total number of violent acts while hospitalized, age at admission, treating hospital, level of functioning at admission, ethnicity, sex, and having had a previous state hospital admission were evaluated using a parametric survival model.

Results

The analysis showed that the most important variables related to length of stay were (1) diagnosis, (2) number of violent acts while hospitalized, and (3) age of admission. Specifically, longer length of stay was associated with (1) having a diagnosis of schizophrenia or neurocognitive disorder, (2) one or more violent acts, and (3) older age at admission. The other variables studied were also statistically significant, but not as influential in the model.

Conclusions

We found significant relations between length of stay and the variables studied, with the most important variables being (1) diagnosis, (2) number of physically violent acts, and (3) age at admission. These findings emphasize the need for treatments to target cognitive issues in the seriously mentally ill as well as treatment of violence and early identification of violence risk factors.

Keywords

Competency to stand trialinpatientlength of stayvariable importanceviolencecognition.
Type
Original Research
Information
CNS Spectrums , Volume 25 , Issue 5 , October 2020 , pp. 734 - 742
Copyright
© Cambridge University Press 2020

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