Length of stay and associated factors in patients with schizophrenia and schizoaffective disorder in a specialised psychiatric hospital

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dc.contributor.authorGoga, Ladawa Yasese
dc.date.accessioned2022-08-29T10:45:11Z
dc.date.available2022-08-29T10:45:11Z
dc.date.issued2021
dc.descriptionA research report submitted to the Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, in partial fulfilment of the requirements for the degree of Master of Medicine in Psychiatry, 2021en_ZA
dc.description.abstractBackground: Patients with schizophrenia and schizoaffective disorder often require long admissions. There exists a progressive shortage of beds in South African psychiatric hospitals and investigating current length of stay (LOS) trends is necessary to better inform future health system planning. Aim: To explore LOS and associated factors of patients with schizophrenia and schizoaffective disorder, at a public sector specialised psychiatric hospital, over a 4- year period. Setting: The study was conducted at Tara Hospital, in Johannesburg, South Africa. Methods: A retrospective record review of 367 adult schizophrenia and schizoaffective disorder patients was conducted. Average LOS was calculated and the proportion of short-stay (<30 days), medium-stay (31-90 days) and long-stay (>90 days) admissions determined. Further data was collected, from a randomly selected subset of patients in each LOS category, regarding sociodemographic, clinical and admission outcome factors. Results: Mean LOS was 128 days (median 87, IQR 49-164, range 0-755 days). A significantly greater proportion of patients had long-stay admissions (p<0.001). Male gender (p=0.018), being unmarried (p=0.006), treatment resistant (p<0.001) and on clozapine (p=0.009) were factors found to have a significant association with long-stay admissions. Overall, rates of unemployment (>80%), comorbid substance use disorders (>40%), medical illnesses (>40%), antipsychotic polypharmacy (>40%) and readmissions (>80%) were high. Of those with treatment resistance, approximately half were discharged on clozapine. Most (>80%) were discharged home, despite psychiatric residential placement being recommended. Conclusion: Long-stay admissions were frequently required for patients with schizophrenia and schizoaffective disorder admitted to Tara Hospital. More research is needed into whether increased and improved community-based services such as residential and day-care facilities could translate into shorter admissions, less frequent relapses and improved outcomes in this populationen_ZA
dc.description.librarianCK2022en_ZA
dc.facultyFaculty of Health Sciencesen_ZA
dc.identifier.urihttps://hdl.handle.net/10539/33119
dc.language.isoenen_ZA
dc.titleLength of stay and associated factors in patients with schizophrenia and schizoaffective disorder in a specialised psychiatric hospitalen_ZA
dc.typeThesisen_ZA
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