{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,29]],"date-time":"2026-08-29T06:09:19Z","timestamp":1787983759711,"version":"build-2784847793"},"reference-count":53,"publisher":"MDPI AG","issue":"22","license":[{"start":{"date-parts":[[2022,11,16]],"date-time":"2022-11-16T00:00:00Z","timestamp":1668556800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100000024","name":"Canadian Institutes of Health Research","doi-asserted-by":"publisher","award":["8400997"],"award-info":[{"award-number":["8400997"]}],"id":[{"id":"10.13039\/501100000024","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["IJERPH"],"abstract":"<jats:p>Length of hospitalization, if inappropriate to patient needs, may be associated with early readmission, reflecting sub-optimal hospital treatment, and translating difficulties to access outpatient care after discharge. This study identified predictors of brief-stay (1\u20136 days), mid-stay (7\u201330 days) or long-stay (\u226531 days) hospitalization, and evaluated how lengths of hospital stay impacted on early readmission (within 30 days) among 3729 patients with mental disorders (MD) or substance-related disorders (SRD). This five-year cohort study used medical administrative databases and multinomial logistic regression. Compared to patients with brief-stay or mid-stay hospitalization, more long-stay patients were 65+ years old, had serious MD, and had a usual psychiatrist rather than a general practitioner (GP). Predictors of early readmission were brief-stay hospitalization, residence in more materially deprived areas, more diagnoses of MD\/SRD or chronic physical illnesses, and having a usual psychiatrist with or without a GP. Patients with long-stay hospitalization (\u226531 days) and early readmission had more complex conditions, especially more co-occurring chronic physical illnesses, and more serious MD, while they tended to have a usual psychiatrist with or without a GP. For patients with more complex conditions, programs such as assertive community treatment, intensive case management or home treatment would be advisable, particularly for those living in materially deprived areas.<\/jats:p>","DOI":"10.3390\/ijerph192215127","type":"journal-article","created":{"date-parts":[[2022,11,17]],"date-time":"2022-11-17T03:12:20Z","timestamp":1668654740000},"page":"15127","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":12,"title":["Predictors of Length of Hospitalization and Impact on Early Readmission for Mental Disorders"],"prefix":"10.3390","volume":"19","author":[{"given":"Lia","family":"Gentil","sequence":"first","affiliation":[{"name":"Department of Psychiatry, McGill University, 1033, Pine Avenue West, Montreal, QC H3A 1A1, Canada"},{"name":"Douglas Hospital Research Centre, Douglas Mental Health University Institute, 6875 LaSalle Blvd, Montreal, QC H4H 1R3, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2445-0060","authenticated-orcid":false,"given":"Guy","family":"Grenier","sequence":"additional","affiliation":[{"name":"Douglas Hospital Research Centre, Douglas Mental Health University Institute, 6875 LaSalle Blvd, Montreal, QC H4H 1R3, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0186-6060","authenticated-orcid":false,"given":"Helen-Maria","family":"Vasiliadis","sequence":"additional","affiliation":[{"name":"D\u00e9partement Des Sciences de la Sant\u00e9 Communautaire, Universit\u00e9 de Sherbrooke, Longueuil, QC J4K 0A8, Canada"},{"name":"Centre de Recherche Charles-Le Moyne-Saguenay-Lac-Saint-Jean sur les Innovations en Sant\u00e9 (CR-CSIS), Campus de Longueuil-Universit\u00e9 de Sherbrooke, 150 Place Charles-Lemoyne, Longueuil, QC J4K 0A8, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marie-Jos\u00e9e","family":"Fleury","sequence":"additional","affiliation":[{"name":"Department of Psychiatry, McGill University, 1033, Pine Avenue West, Montreal, QC H3A 1A1, Canada"},{"name":"Douglas Hospital Research Centre, Douglas Mental Health University Institute, 6875 LaSalle Blvd, Montreal, QC H4H 1R3, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2022,11,16]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"129","DOI":"10.1007\/s11126-016-9440-4","article-title":"Predictors of Length of Stay in an Inpatient Psychiatric Unit of a General Hospital in Perugia, Italy","volume":"88","author":"Pauselli","year":"2017","journal-title":"Psychiatr. Q."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"63","DOI":"10.1016\/j.genhosppsych.2017.11.008","article-title":"Readmission in psychiatry inpatients within a year of discharge: The role of symptoms at discharge and post-discharge care in a Brazilian sample","volume":"51","author":"Baeza","year":"2018","journal-title":"Gen. Hosp. Psychiatry"},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"433","DOI":"10.1007\/s10488-009-0263-6","article-title":"Post-discharge services and psychiatric rehospitalization among children and youth","volume":"37","author":"James","year":"2010","journal-title":"Adm. Policy Ment. Health"},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"1225","DOI":"10.1176\/appi.ps.003382012","article-title":"Risk factors for early readmission to acute care for persons with schizophrenia taking antipsychotic medications","volume":"64","author":"Boaz","year":"2013","journal-title":"Psychiatr. Serv."},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"181","DOI":"10.1017\/S2045796015000128","article-title":"Exploring the predictors of early readmission to psychiatric hospital","volume":"25","author":"Tulloch","year":"2016","journal-title":"Epidemiol. Psychiatr. Sci."},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"804","DOI":"10.1007\/s10597-018-0316-y","article-title":"Factors Associated with Rapid Readmission Among Nevada State Psychiatric Hospital Patients","volume":"55","author":"Moore","year":"2019","journal-title":"Community Ment. Health J."},{"key":"ref_7","unstructured":"OECD (2013). Unplanned hospital re-admissions for patients with mental disorders. Health at a Glance 2013: OECD Indicators, OECD Publishing."},{"key":"ref_8","doi-asserted-by":"crossref","unstructured":"Lassemo, E., Myklebust, L.H., Salazzari, D., and Kalseth, J. (2021). Psychiatric readmission rates in a multi-level mental health care system\u2014A descriptive population cohort study. BMC Health Serv. Res., 21.","DOI":"10.1186\/s12913-021-06391-7"},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"53","DOI":"10.1016\/j.genhosppsych.2015.10.009","article-title":"Pre- and post-discharge factors influencing early readmission to acute psychiatric wards: Implications for quality-of-care indicators in psychiatry","volume":"39","author":"Donisi","year":"2016","journal-title":"Gen. Hosp. Psychiatry"},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"228","DOI":"10.1097\/JHQ.0000000000000162","article-title":"Predictors of 30-day Postdischarge Readmission to a Multistate National Sample of State Psychiatric Hospitals","volume":"41","author":"Ortiz","year":"2019","journal-title":"J. Healthc. Qual."},{"key":"ref_11","doi-asserted-by":"crossref","unstructured":"Han, X., Jiang, F., Tang, Y., Needleman, J., Guo, M., Chen, Y., Zhou, H., and Liu, Y. (2020). Factors associated with 30-day and 1-year readmission among psychiatric inpatients in Beijing China: A retrospective, medical record-based analysis. BMC Psychiatry, 20.","DOI":"10.1186\/s12888-020-02515-1"},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"675","DOI":"10.1007\/s10597-015-9921-1","article-title":"Risk Factors for Inpatient Psychiatric Readmission: Are There Gender Differences?","volume":"52","author":"Rieke","year":"2016","journal-title":"Community Ment. Health J."},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"1411","DOI":"10.1007\/s00127-019-01717-7","article-title":"Identifying patterns in psychiatric hospital stays with statistical methods: Towards a typology of post-deinstitutionalization hospitalization trajectories","volume":"54","author":"Golay","year":"2019","journal-title":"Soc. Psychiatry Psychiatr. Epidemiol."},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"271","DOI":"10.1080\/13651501.2017.1324037","article-title":"Rapid and frequent psychiatric readmissions: Associated factors","volume":"21","author":"Evans","year":"2017","journal-title":"Int. J. Psychiatry Clin. Pract."},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"33","DOI":"10.1007\/s11126-017-9498-7","article-title":"Factors Associated with Length of Stay in Psychiatric Inpatient Services in London, UK","volume":"89","author":"Newman","year":"2018","journal-title":"Psychiatr. Q."},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"238","DOI":"10.3109\/13651501.2015.1062522","article-title":"Predictors of length of stay in a psychiatric hospital","volume":"19","author":"Gopalakrishna","year":"2015","journal-title":"Int. J. Psychiatry Clin. Pract."},{"key":"ref_17","doi-asserted-by":"crossref","unstructured":"Crossley, N., and Sweeney, B. (2020). Patient and service-level factors affecting length of inpatient stay in an acute mental health service: A retrospective case cohort study. BMC Psychiatry, 20.","DOI":"10.1186\/s12888-020-02846-z"},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"681","DOI":"10.1016\/j.comppsych.2013.11.004","article-title":"Factors associated with length of psychiatric hospitalization","volume":"55","author":"Masters","year":"2014","journal-title":"Compr. Psychiatry"},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"426","DOI":"10.1016\/j.comppsych.2013.11.019","article-title":"Predictors of readmission to a psychiatry inpatient unit","volume":"55","author":"Moss","year":"2014","journal-title":"Compr. Psychiatry"},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"262","DOI":"10.1007\/s11414-014-9400-4","article-title":"Effectiveness of a Brief Care Management Intervention for Reducing Psychiatric Hospitalization Readmissions","volume":"43","author":"Taylor","year":"2016","journal-title":"J. Behav. Health Serv. Res."},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"214","DOI":"10.1016\/j.pmedr.2018.10.007","article-title":"Medical multimorbidity and drug use among adults in the United States","volume":"12","author":"Han","year":"2018","journal-title":"Prev. Med. Rep."},{"key":"ref_22","doi-asserted-by":"crossref","unstructured":"Wolff, J., McCrone, P., Patel, A., Kaier, K., and Normann, C. (2015). Predictors of length of stay in psychiatry: Analyses of electronic medical records. BMC Psychiatry, 15.","DOI":"10.1186\/s12888-015-0623-6"},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"22","DOI":"10.1097\/QMH.0000000000000077","article-title":"Risk Factors for Readmission on an Adult Inpatient Psychiatric Unit","volume":"25","author":"Rylander","year":"2016","journal-title":"Qual. Manag. Health Care"},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"113168","DOI":"10.1016\/j.psychres.2020.113168","article-title":"Factors associated with 30-day readmissions following medical hospitalizations among Medicaid beneficiaries with schizophrenia, bipolar disorder, and major depressive disorder","volume":"291","author":"Cook","year":"2020","journal-title":"Psychiatry Res."},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"207","DOI":"10.1007\/s11414-013-9323-5","article-title":"Hospital readmission among medicaid patients with an index hospitalization for mental and\/or substance use disorder","volume":"40","author":"Mark","year":"2013","journal-title":"J. Behav. Health Serv. Res."},{"key":"ref_26","unstructured":"R\u00e9gie de L\u2019assurance Maladie du Qu\u00e9bec (2017). Nombre de M\u00e9decins Montant Total et Montant Moyen Selon la Cat\u00e9gorie de M\u00e9decins, le Groupe de Sp\u00e9cialit\u00e9s, la Sp\u00e9cialit\u00e9 et le Mode de R\u00e9mun\u00e9ration, Services M\u00e9dicaux. Available online: https:\/\/www4.prod.ramq.gouv.qc.ca\/IST\/CD\/CDF_DifsnInfoStats\/CDF1_CnsulInfoStatsCNC_iut\/RappPDF.aspx?TypeImpression=pdf&NomPdf=CBB7R05A_SM24_2017_0_O.PDF."},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"575","DOI":"10.1007\/s00127-016-1175-x","article-title":"Impact of length of stay for first psychiatric admissions on the ratio of readmissions in subsequent years in a large Brazilian catchment area","volume":"51","author":"Barros","year":"2016","journal-title":"Soc. Psychiatry Psychiatr. Epidemiol."},{"key":"ref_28","doi-asserted-by":"crossref","unstructured":"Marfil-Garza, B.A., Belaunzaran-Zamudio, P.F., Gulias-Herrero, A., Zuniga, A.C., Caro-Vega, Y., Kershenobich-Stalnikowitz, D., and Sifuentes-Osornio, J. (2018). Risk factors associated with prolonged hospital length-of-stay: 18-year retrospective study of hospitalizations in a tertiary healthcare center in Mexico. PLoS ONE, 13.","DOI":"10.1371\/journal.pone.0207203"},{"key":"ref_29","doi-asserted-by":"crossref","unstructured":"Baek, H., Cho, M., Kim, S., Hwang, H., Song, M., and Yoo, S. (2018). Analysis of length of hospital stay using electronic health records: A statistical and data mining approach. PLoS ONE, 13.","DOI":"10.1371\/journal.pone.0195901"},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"178","DOI":"10.24095\/hpcdp.29.4.05","article-title":"A deprivation index for health planning in Canada","volume":"29","author":"Pampalon","year":"2009","journal-title":"Chronic Dis. Can."},{"key":"ref_31","unstructured":"Simard, M., Dub\u00e9, M., Myles, G., and Sirois, C. (2019). La Pr\u00e9valence de la Multimorbidit\u00e9 au Qu\u00e9bec: Portrait pour L\u2019ann\u00e9e 2016\u20132017, Institut National de Sant\u00e9 Publique Du Qu\u00e9bec."},{"key":"ref_32","doi-asserted-by":"crossref","first-page":"382","DOI":"10.1177\/0706743716639054","article-title":"Correlates of Attempted Suicide from the Emergency Room of 2 General Hospitals in Montreal, Canada","volume":"61","author":"Rahme","year":"2016","journal-title":"Can. J. Psychiatry"},{"key":"ref_33","doi-asserted-by":"crossref","first-page":"1499","DOI":"10.1007\/s11606-008-0692-z","article-title":"Primarye physician visit continuity: A comparison of patient-reported and administratively derived measures","volume":"23","author":"Rodriguez","year":"2008","journal-title":"J. Gen. Intern. Med."},{"key":"ref_34","unstructured":"V\u00e9rificateur G\u00e9n\u00e9ral du Qu\u00e9bec (2015). Rapport du V\u00e9rificateur G\u00e9n\u00e9ral du Qu\u00e9bec \u00e0 l\u2019Assembl\u00e9e Nationale pour L\u2019ann\u00e9e 2015\u20132016. V\u00e9rification de L\u2019optimisation des Ressources, Automne 2015, V\u00e9rificateur G\u00e9n\u00e9ral du Qu\u00e9bec."},{"key":"ref_35","doi-asserted-by":"crossref","first-page":"21","DOI":"10.1186\/2045-4015-1-21","article-title":"The association between continuity of care in the community and health outcomes: A population-based study","volume":"1","author":"Dreiher","year":"2012","journal-title":"Isr. J. Health Policy Res."},{"key":"ref_36","first-page":"965","article-title":"Continuity of care in a university-based practice","volume":"50","author":"Breslau","year":"1975","journal-title":"J. Med. Educ"},{"key":"ref_37","doi-asserted-by":"crossref","first-page":"1362","DOI":"10.1503\/cmaj.061615","article-title":"Continuity of primary care and emergency department utilization among elderly people","volume":"177","author":"McCusker","year":"2007","journal-title":"CMAJ"},{"key":"ref_38","doi-asserted-by":"crossref","first-page":"E724","DOI":"10.1503\/cmaj.181712","article-title":"Combined impacts of multimorbidity and mental disorders on frequent emergency department visits: A retrospective cohort study in Quebec, Canada","volume":"191","author":"Gaulin","year":"2019","journal-title":"CMAJ"},{"key":"ref_39","doi-asserted-by":"crossref","unstructured":"Krieg, C., Hudon, C., Chouinard, M.C., and Dufour, I. (2016). Individual predictors of frequent emergency department use: A scoping review. BMC Health Serv. Res., 16.","DOI":"10.1186\/s12913-016-1852-1"},{"key":"ref_40","doi-asserted-by":"crossref","first-page":"1239","DOI":"10.1176\/appi.ps.201600498","article-title":"Outpatient Follow-Up Care and Risk of Hospital Readmission in Schizophrenia and Bipolar Disorder","volume":"68","author":"Marcus","year":"2017","journal-title":"Psychiatr. Serv."},{"key":"ref_41","doi-asserted-by":"crossref","first-page":"155","DOI":"10.1007\/s10488-010-0310-3","article-title":"Length of stay of general psychiatric inpatients in the United States: Systematic review","volume":"38","author":"Tulloch","year":"2011","journal-title":"Adm. Policy Ment. Health"},{"key":"ref_42","doi-asserted-by":"crossref","unstructured":"Bartoli, F., Cavaleri, D., Moretti, F., Bachi, B., Calabrese, A., Callovini, T., Cioni, R.M., Riboldi, I., Nacinovich, R., and Crocamo, C. (2020). Pre-Discharge Predictors of 1-Year Rehospitalization in Adolescents and Young Adults with Severe Mental Disorders: A Retrospective Cohort Study. Medicina, 56.","DOI":"10.3390\/medicina56110613"},{"key":"ref_43","first-page":"e15602","article-title":"Substance Use Disorders (SUD) and Suicidal Behaviors in Adolescents: Insights From Cross-Sectional Inpatient Study","volume":"13","author":"Basith","year":"2021","journal-title":"Cureus"},{"key":"ref_44","doi-asserted-by":"crossref","first-page":"112810","DOI":"10.1016\/j.psychres.2020.112810","article-title":"Frequency of rehospitalization after hospitalization for suicidal ideation or suicidal behavior in patients with depression","volume":"285","author":"Cepeda","year":"2020","journal-title":"Psychiatry Res."},{"key":"ref_45","doi-asserted-by":"crossref","unstructured":"Fleury, M.J., Grenier, G., Vallee, C., Aube, D., Farand, L., Bamvita, J.M., and Cyr, G. (2016). Implementation of the Quebec mental health reform (2005\u20132015). BMC Health Serv. Res., 16.","DOI":"10.1186\/s12913-016-1832-5"},{"key":"ref_46","doi-asserted-by":"crossref","first-page":"983","DOI":"10.1377\/hlthaff.2015.1619","article-title":"Building the Mental Health Workforce Capacity Needed to Treat Adults with Serious Mental Illnesses","volume":"35","author":"Olfson","year":"2016","journal-title":"Health Affairs (Project Hope)"},{"key":"ref_47","doi-asserted-by":"crossref","first-page":"7","DOI":"10.5334\/ijic.2457","article-title":"Implementing Key Strategies for Successful Network Integration in the Quebec Substance-Use Disorders Programme","volume":"16","author":"Fleury","year":"2016","journal-title":"Int. J. Integr. Care"},{"key":"ref_48","doi-asserted-by":"crossref","first-page":"151","DOI":"10.1080\/00952990.2017.1306747","article-title":"Combining medically assisted treatment and Twelve-Step programming: A perspective and review","volume":"44","author":"Galanter","year":"2018","journal-title":"Am. J. Drug Alcohol Abuse"},{"key":"ref_49","doi-asserted-by":"crossref","first-page":"301","DOI":"10.1176\/appi.ps.201300242","article-title":"Residential treatment for individuals with substance use disorders: Assessing the evidence","volume":"65","author":"Reif","year":"2014","journal-title":"Psychiatr. Serv."},{"key":"ref_50","unstructured":"Gouvernement du Qu\u00e9bec (2022). S\u2019unir pour un Mieux-\u00catre Collectif. Plan D\u2019action Interminist\u00e9riel en Sant\u00e9 Mentale 2022\u20132026, Direction des Communications du Minist\u00e8re de la Sant\u00e9 et des Services Sociaux."},{"key":"ref_51","doi-asserted-by":"crossref","first-page":"458","DOI":"10.1016\/j.schres.2014.11.021","article-title":"Factors associated with co-occurring medical conditions among adults with serious mental disorders","volume":"161","author":"Razzano","year":"2015","journal-title":"Schizophr. Res."},{"key":"ref_52","doi-asserted-by":"crossref","first-page":"293","DOI":"10.3109\/13651501.2012.667115","article-title":"Shared care between specialised psychiatric services and primary care: The experiences and expectations of General Practitioners in Ireland","volume":"16","author":"Agyapong","year":"2012","journal-title":"Int. J. Psychiatry Clin. Pract."},{"key":"ref_53","doi-asserted-by":"crossref","first-page":"e113","DOI":"10.3399\/bjgp20X713969","article-title":"Identifying patients at risk of psychosis: A qualitative study of GP views in South-West England","volume":"71","author":"Strelchuk","year":"2021","journal-title":"Br. J. Gen. Pract."}],"container-title":["International Journal of Environmental Research and Public Health"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/1660-4601\/19\/22\/15127\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,11]],"date-time":"2025-10-11T01:19:40Z","timestamp":1760145580000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/1660-4601\/19\/22\/15127"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2022,11,16]]},"references-count":53,"journal-issue":{"issue":"22","published-online":{"date-parts":[[2022,11]]}},"alternative-id":["ijerph192215127"],"URL":"https:\/\/doi.org\/10.3390\/ijerph192215127","relation":{},"ISSN":["1660-4601"],"issn-type":[{"value":"1660-4601","type":"electronic"}],"subject":[],"published":{"date-parts":[[2022,11,16]]}}}