Inpatient, outpatient, and partial hospitalization use all show recent growth, while treatment in residential facilities appears to be declining.
The need for psychiatric services in inpatient hospitals continues to grow, according to an annual survey by the National Association of Psychiatric Health Systems (NAPHS).
Inpatient hospital admissions, lengths of stay, and days of care for psychiatric services all increased in 2012, according to “Behavioral Healthcare Delivery Today: 2013 Annual NAPHS Survey Results.” The survey reports 2012 data from NAPHS member organizations.
NAPHS President and CEO Mark Covall states in an overview of the report that service utilization showed growth across all treatment settings, except residential treatment facilities. NAPHS member organizations provide psychiatric care in a continuum of settings including inpatient hospital, residential, partial hospital, and outpatient.
“While. . . inpatient days of care increased by 5.4 percent since 2011, outpatient services also showed growth, with the average number of outpatient visits in 2012 increasing by 6.6 percent since the prior year,” he said. “The average number of partial hospitalization visits also increased substantially (14.6 percent) from 2011 to 2012, [while] utilization days of psychiatric services in residential treatment centers decreased slightly (3.8 percent) from 2011 to 2012, with members reporting both a lower number of admissions and a shorter average length of stay.”
The report provides a wealth of information on psychiatric service utilization. One chapter provides a trend analysis that looks at changes from year to year in NAPHS member hospitals and residential treatment centers. Another chapter provides national averages to give a snapshot of members’ experiences in the reporting year; that chapter also presents selected data by set-up-and-staffed bed categories to help organizations compare their experiences with those of facilities of a similar size. Data drawn from other major studies are also presented to provide context on the prevalence of mental health conditions.
A sample of major findings include the following:
Inpatient length of stay. Lengths of stay in inpatient hospital programs varied by program and ranged from 7.6 to 13.4 days in 2012. The average length of stay in alcohol and drug programs for adults was the shortest at 7.6 days. The average length of stay for older adults was the longest across the seven program types at 13.4 days (see chart).
Outpatient utilization. In 2012 there was an average of 4,406 outpatient visits within NAPHS-member specialty hospitals and psychiatric units. This number is based on data for hospitals of all types—including psychiatric hospitals and general hospital behavioral health units. Facilities with fewer than 50 beds had an average of 2,760 outpatient visits (1,530 regular visits and 3,622 intensive visits), those with 50 to 100 beds had an average of 2,795 outpatient visits (1,916 regular visits and 3,408 intensive visits), and those with more than 100 beds had an average of 7,555 outpatient visits (9,664 regular visits and 5,914 intensive visits).
Residential treatment services. In 2012, residential treatment centers of all types (hospital-based and freestanding residential treatment centers combined) with fewer than 50 beds averaged 233 admissions and delivered 10,855 days of care. Those with 50 to 100 beds averaged 247 admissions and delivered 22,828 days of care, while those with more than 100 beds averaged 433 admissions totaling 38,812 days of care. The average length of stay in residential treatment centers in 2012 was 79 days.
“According to recent estimates, between 19 percent and 25 percent of adults experience a mental illness in a given year,” Covall said. “These individuals not only face mental health issues, but are also more likely to have physical health and substance abuse problems and, ultimately, shorter lifespans. This year’s survey demonstrates a continued need for our members’ services as an essential part of the health care delivery system.” ■
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