Emergency psychiatry providers must frequently manage severe psychiatric and behavioral crises, which can be taxing for both patients and healthcare systems. While patient stabilization and safety will always remain the largest priority when determining the duration of treatment, protocols that reduce the length of stay while maintaining the optimal standard of care will allow psychiatric facilities to allocate resources to a wider range of the patient pool. The purpose of this article is to examine if the choice of neuroleptic medication played a role in the length of stay for hospitalizations due to acute psychosis. This was conducted through a retrospective review of patient records at Arrowhead Regional Medical Center’s Behavioral Health Unit for the umbrella of psychotic disorder, looking at seven commonly used neuroleptic medications. The retrospective review showed that the use of Aripiprazole resulted in a statistically significant lower length of stay when compared to the other neuroleptic medications, aside from Ziprasidone given its limited sample size. All other medications considered showed no statistical difference from each other in their length of stay. This finding could have important implications on a macro level in determining which medications to consider in patients who have not already displayed clinical improvement with a particular neuroleptic medication prior, in order to effectively utilize resources in an emergency psychiatry setting. Given this study is a preliminary analysis, there are some limitations that warrant further investigation to augment its significance. Suggestions for expansion of this research include differentiating the effects of neuroleptic medications on length of stay amongst specific subsets of psychotic diagnoses, evaluating possible confounding effects of commonly and concomitantly prescribed medications such as mood stabilizers or antidepressants, and determining the role of long-acting injectable medications in length of hospital stay. Overall, this article can provide a stepping stone for physicians looking at secondary factors in determining medication choice in an emergency psychiatry setting, integrating resource utilization with patient management.
Learning Objectives
Examining length of stay for patients experiencing psychosis
Evaluating time for stabilization for neuroleptic medications
Investigating the cost analysis for neuroleptic medications
