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Length of Stay and Direct Medical Costs for Psychogeriatric Inpatients in Taiwan

Chin-Ming Liu, Chu-Shiu Li, Chwen-Chi Liu, Chu-Chin Tu

Objective: In this study, we aimed to analyze the length of stay (LOS) and direct
medical costs (DMC) for psychogeriatric inpatients in Taiwan. Methods: We
obtained the data from the Psychiatric Inpatient Medical Claim database of Taiwan’s
National Health Insurance. LOS and DMC of different mental illnesses were
analyzed. Results: The average LOS of our study patients was 43.53 days, and the
mean DMC was 2,576 US dollars. Dementia was the most common psychiatric diagnosis.
Average LOS and DMC were signifi cantly higher in male patients than
female (p < 0.001 and p = 0.022, respectively). Over 90% of DMC were non-drug
expenses (NDE). The LOS of patients with dementia and major depression was
signifi cantly higher for males than for females (p < 0.001). Patients’ LOS and
DMC showed differences among gender, diagnosis, and type of hospital. The LOS
of dementia and delusional disorders and the DMC of major depressive disorders
had heterogeneities across hospital types. The results of regression analysis indicated
the LOS and the DMC of schizophrenic patients were signifi cantly higher
than those of dementia patients (p < 0.001); the LOS of community hospitals was
signifi cantly higher (p < 0.001) than that of general hospitals (medical centers and
regional hospitals), with the opposite being true for DMC. Compared to public
hospitals, the drug expense (DE) was signifi cantly higher in private hospitals (p <
0.04), but LOS and NDE were lower. Conclusion: The determinants affecting differences
of LOS and DMC of psychogeriatric inpatients were gender, psychiatric
diagnosis, and type of hospital. The DE and NDE of DMC were about 10% and
90%, respectively, but only the NDE showed signifi cant difference based on
gender.
Key Word length of stay, direct medical cost, geriatrics
Editorial Committe, Taiwanese Journal of Psychiatry
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