Abstract:
Background: In sub-Saharan Africa, the number of psychiatric beds per population is disproportionately low.
Moreover, there is a lack of data regarding the patterns of psychiatric admissions and the factors leading to long
psychiatric hospitalization in this region. This study aimed to investigate the average length of stay (LOS) and the
factors associated with prolonged hospitalizations.
Methods: A ten-year retrospective chart review of patients admitted to the psychiatric facility of Jimma University
Specialized Hospital in southwest Ethiopia was conducted. The medical charts of 846 admissions spanning the period
from January 2001 to December 2010 were reviewed. LOS greater than 21 days was considered as a cut-off point for
lengthier stay. Bivariate and multivariable logistic regression analyses were conducted to identify factors independently
associated with LOS.
Results: The most common discharge diagnoses were schizophrenia and other psychotic disorders (27.6%),
and bipolar disorder (23.4%). A global clinical rating taken on discharge showed 90.3% improved outcome. The
median (25th, 75th percentiles) LOS was 22 (15, 36) days. Patients with major depressive disorder [aOR = 0.51 (0.32 –
0.81)] and brief psychotic disorder [aOR = 0.52 (0.33 – 0.84)] were less likely than patients with schizophrenia and other
psychotic disorders to have long hospital stays. Presence of extrapyramidal side-effects and out of pocket expenditures
predicted LOS.
Conclusions: Patients with psychoses and bipolar disorder have lengthier hospital stays burdening the cost of care of
psychiatric treatment in a general hospital setting. Our findings call for identifying those cases quickly, attending to their
needs with evidence-based efficient treatment and for improving and developing an aftercare system such that the
utilization of acute inpatient beds, already a scarce resource, could achieve higher efficiency.
