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Article
Publication date: 12 March 2018

Mostafa Mohamed Al Sayed and Michael Elnemais Fawzy

The purpose of this paper is to study the role of social factors that determine the length of stay in a mental hospital and also understand the main factors leading to the…

Abstract

Purpose

The purpose of this paper is to study the role of social factors that determine the length of stay in a mental hospital and also understand the main factors leading to the phenomena as a step to solve it.

Design/methodology/approach

A case-control cross-sectional observational study is performed which studies correlates for the lengthy stay in a mental hospital. The study population consists of two groups: Group A (94 patients), taken from the patients hospitalized for more than one year, further subdivided into schizophrenia and schizoaffective inpatient group and bipolar affective inpatient group; and Group B (94 patients), receiving their treatment at the outpatient clinic after being admitted for less than six months, this group was further subdivided into same categories as Group A.

Findings

The study showed that the positive score in positive and negative symptoms scale (PANSS) showed highly statistically significant (p<0.01) correlation with the length of hospital stay for the schizophrenic and schizoaffective patients in the inpatient group. The results showed no statistically significant difference (p>0.05) between the inpatient schizophrenic cases and the inpatient affective cases regarding the length of hospital stay.

Research limitations/implications

The linear regression model was used to understand the predictors of increased length of hospital stay. The linear regression analyzing the scale data of schizophrenic and schizoaffective patients found that the length of hospital stay for the schizophrenic and schizoaffective patients depends on the patient’s age and his positive PANSS score. On the other hand, linear regression model for bipolar affective patients in the study found no statistically significant attributes of the length of hospital stay.

Practical implications

The study found that the length of hospital stay for schizophrenic and schizoaffective patients depends on the patient’s age and his positive PANSS score.

Social implications

The need for this study stems from the large numbers of mental inpatients who have been lengthily admitted in mental health hospitals in Egypt, while trying to understand main factors leading to the phenomena as a step to solve it. The study found that there is a highly significant difference between inpatient group and outpatient group regarding the marital status, education level, and psychosocial class, with inpatient group having more single, illiterate, and very low social class cases.

Originality/value

Research in the area of chronic psychiatric hospitalization and its effect on the course and prognosis of mental illness is still scarce, especially in the Arab world; therefore, the research will open the door for further research efforts in the future with a larger sample of patients to study the pros and cons of deinstitutionalization taking into account the past experience of health systems in other countries.

Details

International Journal of Human Rights in Healthcare, vol. 11 no. 1
Type: Research Article
ISSN: 2056-4902

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Article
Publication date: 24 January 2011

Regi Alexander, Avinash Hiremath, Verity Chester, Fatima Green, Ignatius Gunaratna and Sudeep Hoare

The aim of the project was to evaluate the short‐term treatment outcomes of patients treated in a medium secure service for people with intellectual disability. A total of

Abstract

The aim of the project was to evaluate the short‐term treatment outcomes of patients treated in a medium secure service for people with intellectual disability. A total of 138 patients, 77 discharged and 61 current inpatients, treated over a six‐year period were included in the audit. Information on demographic and clinical variables was collected on a pre‐designed data collection tool and analysed using appropriate statistical methods. The median length of stay for the discharged group was 2.8 years. About 90% of this group were discharged to lower levels of security and about a third went directly to community placements. None of the clinical and forensic factors examined was significantly associated with length of stay for this group. There was a ‘difficult to discharge long‐stay’ group which had more patients with criminal sections, restriction orders, history of abuse, fire setting, personality disorders and substance misuse. However, when regression analysis was done, most of these factors were not predictive of the length of stay. Clinical diagnosis or offending behaviour categories are poor predictors of length of hospital stay, and there is a need to identify empirically derived patient clusters using a variety of clinical and forensic variables. Common datasets and multi‐centre audits are needed to drive this.

Details

Advances in Mental Health and Intellectual Disabilities, vol. 5 no. 1
Type: Research Article
ISSN: 2044-1282

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Article
Publication date: 23 December 2020

Ozan Atsız, Veronica Leoni and Orhan Akova

This paper aims to empirically analyze tourists' length of stay in Istanbul, an important cultural destination. The objective of the study is twofold: (1) uncovering the…

Abstract

Purpose

This paper aims to empirically analyze tourists' length of stay in Istanbul, an important cultural destination. The objective of the study is twofold: (1) uncovering the qualitative difference between one-night visitors and longer stay visitors and (2) for those visitors staying longer at the tourism destination, investigating the key determinants of length of stay.

Design/methodology/approach

This research was carried out using a self-administered questionnaire distributed to international tourists who were about to leave the destination. To perform the analysis, we applied a two-step approach: first, we opted for classical binary logit to investigate the tourists' group membership (one-night vs longer stays); second, we applied a zero-truncated Poisson model for uncovering the drivers of length of stay for longer stay visitors.

Findings

The results confirmed the structural difference between the two visitor subgroups. Moreover, we found a positive impact of cultural attributes on tourists' length of stay.

Practical implications

The findings provide useful information for destination managers and planners, highlighting the importance of designing different tourism policies in light of tourists' heterogeneity. Moreover, the results confirmed the importance of the preservation and promotion of cultural attributes, given that these are a key factor in determining the success of a destination.

Originality/value

The importance and originality of this study are that it explores the impact of cultural/heritage attributes of the destination on tourists' length of stay. Moreover, it sheds light on the qualitative difference between short- and long-stay visitors.

Details

Journal of Hospitality and Tourism Insights, vol. ahead-of-print no. ahead-of-print
Type: Research Article
ISSN: 2514-9792

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Article
Publication date: 11 September 2017

Jeffery Cole Kreeger and Scott Smith

The purpose of this paper is to determine how much the lodging shared economy (LSE) utilizes minimum length of stay (MLOS) controls to maximize revenue and reduce…

Abstract

Purpose

The purpose of this paper is to determine how much the lodging shared economy (LSE) utilizes minimum length of stay (MLOS) controls to maximize revenue and reduce housekeeping expense, since cleaning between guest visits represents a substantial variable cost for each guest’s stay. Hosts in the LSE are becoming increasingly perceptive in maximizing revenues.

Design/methodology/approach

Daily data for one year were collected for Vacation Rental by Owner properties in Hilton Head Island, SC and Orlando, FL. The collected data include daily vacancies for two different lengths of stay. Linear regression was used to explore the relationship between relative demand and vacancy length of stay differences.

Findings

During high-demand periods, there were few differences between the availability of short-term and longer-term reservation vacancies, which indicated hosts were not encouraging guests to stay longer during each visit. These results reveal differences in vacancies for three-night vs six-night reservations. A host can generate more revenue and decrease expenses by maximizing booked nights per visit.

Research limitations/implications

Due to confidentiality issues, this study does not capture vacation bookings but instead captures vacancies. In addition, Average Daily Rate was not utilized in this study.

Practical implications

LSE hosts can maximize revenues using MLOS controls. Minimizing housekeeping costs boosts a host’s profitability.

Originality/value

Although this research has been conducted for hotel MLOS, there is a gap in the literature regarding LSE hosts’ use of MLOS.

Details

International Journal of Contemporary Hospitality Management, vol. 29 no. 9
Type: Research Article
ISSN: 0959-6119

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Article
Publication date: 14 September 2015

Wallace Mandell, Victor Lidz and James J. Dahl

Retrospective studies of therapeutic community (TC) treatment for drug abuse found reductions in drug use, criminality, and increased work participation after treatment…

Abstract

Purpose

Retrospective studies of therapeutic community (TC) treatment for drug abuse found reductions in drug use, criminality, and increased work participation after treatment completion. These studies have also shown treatment benefits, even without completion, are correlated with days of stay in residential treatment. However, others have found that high rates of early leaving from TC treatment reduce the proportion of clients with positive outcomes, raise the total cost per treated client, and lower the treatment benefit-to-costs ratio. The purpose of this paper is to describe an experimental approach to raising the days in residential treatment using earlier vocational access for clients.

Design/methodology/approach

The current study used a random assignment design to compare earlier integration of on-site vocational training in a vocationally integrated therapeutic community to off-site vocational training initiated after one year of residence in a traditional therapeutic community.

Findings

The resulting data support the hypotheses that client expectations and early training in job skills increase rate of treatment affiliation, the proportion of clients having effective lengths of stay, and the rate of treatment completion.

Research limitations/implications

Research limitations/implications include the difficulty of assuring unbiased selection and controlling treatment assignment and conditions.

Practical implications

Practical implications of this research project are to support practitioners striving for longer, more effective lengths of stay, while at the same time attempting to reduce treatment time and increase effectiveness.

Social implications

Social Implications of this project are to encourage social support for addiction treatment and emphasize the value of paired residential treatment and vocational education.

Originality/value

The originality and value of this research project lies in the adoption of a working model at Phoenix House TC (in-house vocational preparation), which utilizes early in-house vocational education as a means to increase residential program participation, increase employment skills and prospects, and decrease overall length of treatment.

Details

Therapeutic Communities: The International Journal of Therapeutic Communities, vol. 36 no. 3
Type: Research Article
ISSN: 0964-1866

Keywords

Content available
Article
Publication date: 22 February 2011

Justin B. Dickerson

Episodic mood disorders are often associated with alcohol dependence. Few studies have explored the contribution of episodic mood disorders to length of stay among those…

Abstract

Episodic mood disorders are often associated with alcohol dependence. Few studies have explored the contribution of episodic mood disorders to length of stay among those hospitalized with alcohol dependence syndrome. Filling this research gap could improve care for patients while minimizing hospital utilization costs. This study was a cross-sectional analysis of the National Hospital Discharge Survey. ICD-9-CM diagnosis codes were used to identify those admitted to a private or non-profit hospital with alcohol dependence syndrome, and a co-morbid diagnosis of an episodic mood disorder (n=358). Descriptive statistics were used to highlight differences in key demographic and hospital variables between those with and without episodic mood disorders. Negative binomial regression was used to associate episodic mood disorders with hospital length of stay. Incidence rate ratios were calculated. Co-morbid episodic mood disorders ([.beta]=0.31, P=0.001), referral to a hospital by a physician ([.beta]=0.35, P=0.014), and increasing age ([.beta]= 0.01, P=0.001) were associated with longer hospital stays. Hospital patients with an admitting diagnosis of alcohol dependence syndrome were 36% more likely to have a longer hospital stay if they also had a co-morbid diagnosis of an episodic mood disorder (IRR=1.36, CI=1.14-1.62). Patients admitted to a hospital with alcohol dependence syndrome should be routinely screened for episodic mood disorders. Opportunities exist for enhanced transitional care between acute, ambulatory, and community-based care settings to lower hospital utilization.

Details

Mental Illness, vol. 3 no. 1
Type: Research Article
ISSN: 2036-7465

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Article
Publication date: 6 February 2009

Tim Lockyer and Linda Roberts

The understanding of the factors that influence the selection of accommodation by guests is an important issue for international accommodation providers. The purpose of

Abstract

Purpose

The understanding of the factors that influence the selection of accommodation by guests is an important issue for international accommodation providers. The purpose of this research is to gain a greater understanding not only of the factors that influence the selection of motel accommodation by guests, but also of when and under which situations these factors become trigger points for decision making, focusing in particular on the influence that the length of stay has on the trigger points that impacted the selection process.

Design/methodology/approach

To undertake this research, five focus groups were conducted, involving participants who had previous experience in staying in motel accommodation either for business, on vacation or a combination of the two. Participants were selected and invited from a large variety of occupations and backgrounds.

Findings

Three levels of trigger points were identified for different lengths of stay. For overnight stays requirements were “minimalist”, convenience being the prime trigger point, and visitors felt they could tolerate most situations. For stays of two‐four nights there were certain requirements, “essentials”, that provided the necessary requirements for sleeping, eating and relaxation, while for stays longer than four nights, additional requirements that enhanced the stay, “enhancers”, were sought, raising the provision of the “essentials” to a higher level of sophistication and comfort.

Originality/value

This research, although conducted in New Zealand and in a specific part of a market, illustrates how complex the process of accommodation selection is by guests and in particular how the trigger points for selection change with the length of stay. It indicates how the physical facilities provided need to be tailored to the market in relation to the length of the visitor's stay.

Details

International Journal of Contemporary Hospitality Management, vol. 21 no. 1
Type: Research Article
ISSN: 0959-6119

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Article
Publication date: 15 April 2019

Guillermo A. Sandoval, Adalsteinn D. Brown, Walter P. Wodchis and Geoffrey M. Anderson

The purpose of this paper is to investigate the relationship between hospital adoption and use of computed tomography (CT) scanners, and magnetic resonance imaging (MRI…

Abstract

Purpose

The purpose of this paper is to investigate the relationship between hospital adoption and use of computed tomography (CT) scanners, and magnetic resonance imaging (MRI) machines and in-patient mortality and length of stay.

Design/methodology/approach

This study used panel data (2007–2010) from 124 hospital corporations operating in Ontario, Canada. Imaging use focused on medical patients accounting for 25 percent of hospital discharges. Main outcomes were in-hospital mortality rates and average length of stay. A model for each outcome-technology combination was built, and controlled for hospital structural characteristics, market factors and patient characteristics.

Findings

In 2010, 36 and 59 percent of hospitals had adopted MRI machines and CT scanners, respectively. Approximately 23.5 percent of patients received CT scans and 3.5 percent received MRI scans during the study period. Adoption of these technologies was associated with reductions of up to 1.1 percent in mortality rates and up to 4.5 percent in length of stay. The imaging use–mortality relationship was non-linear and varied by technology penetration within hospitals. For CT, imaging use reduced mortality until use reached 19 percent in hospitals with one scanner and 28 percent in hospitals with 2+ scanners. For MRI, imaging use was largely associated with decreased mortality. The use of CT scanners also increased length of stay linearly regardless of technology penetration (4.6 percent for every 10 percent increase in use). Adoption and use of MRI was not associated with length of stay.

Research limitations/implications

These results suggest that there may be some unnecessary use of imaging, particularly in small hospitals where imaging is contracted out. In larger hospitals, the results highlight the need to further investigate the use of imaging beyond certain thresholds. Independent of the rate of imaging use, the results also indicate that the presence of CT and MRI devices within a hospital benefits quality and efficiency.

Originality/value

To the authors’ knowledge, this study is the first to investigate the combined effect of adoption and use of medical imaging on outcomes specific to CT scanners and MRI machines in the context of hospital in-patient care.

Details

Journal of Health Organization and Management, vol. 33 no. 3
Type: Research Article
ISSN: 1477-7266

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Article
Publication date: 6 August 2018

Thomas Korup Kjærgaard and Natasja Koitzsch Jensen

The purpose of this paper is to examine if the post-migrational risk factors, namely length of stay and number of relocations, are associated with asylum seekers’ mental health.

Abstract

Purpose

The purpose of this paper is to examine if the post-migrational risk factors, namely length of stay and number of relocations, are associated with asylum seekers’ mental health.

Design/methodology/approach

The review includes seven main studies published later than 2006 examining the effect of the asylum procedure on the mental health of asylum seekers. The articles were identified through the search databases PubMed, Embase and PsycINFO. A systematic search strategy based on the concepts of Patient, Intervention, Comparison, and Outcome has laid the groundwork for the findings of relevant articles.

Findings

Two out of three articles investigating the association between number of relocations and mental health among asylum seekers observed an effect on mental health. Three out of six studies found associations between length of stay in asylum centres and poor mental health. The overall assessment of the studies indicates an effect of the post-migrational risk factors.

Research limitations/implications

The included studies vary in study populations, outcome measures and methodical soundness.

Practical implications

The review suggests that length of stay in asylum centres and the number of relocations should be considered as risk factors for poor mental health of asylum seekers and, hence, considered in the organisational procedures in the asylum process.

Originality/value

To the best of the authors’ knowledge, this is the first review to specifically examine the literature on the association between the post-migratory risk factors, number of relocations and length of stay, in asylum centres and mental health among non-detained asylum seekers in Europe.

Details

International Journal of Human Rights in Healthcare, vol. 11 no. 4
Type: Research Article
ISSN: 2056-4902

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Article
Publication date: 3 July 2017

Søren Halkjær and Rainer Lueg

The purpose of this paper is to analyze how specialization in hospitals affects operational performance, measured by the length of stay and readmission rate. The authors…

Abstract

Purpose

The purpose of this paper is to analyze how specialization in hospitals affects operational performance, measured by the length of stay and readmission rate. The authors assess a public policy change in the Danish healthcare sector from 2011 which required that some hospital services had to be centralized leading to specialization within the merged departments.

Design/methodology/approach

Taking an institutional theory perspective, the authors conduct a natural experiment. The data include 24,694 observations of urological patient treatments from 2010 to 2012.

Findings

The econometric difference-in-difference analysis finds that the readmission rate decreases by approximately four percentage points in the departments affected by the policy change. Contrary to expectations, the length of stay increases by 0.38 days. The authors complement the natural experiment with a mixed-methods approach that includes proprietary data from the management control system of the hospital, public documentation on the policy change, as well as interviews with key informants. These data suggest that operational deficiency is related to the fact that specialization was externally enforced through the public policy change. The authors illustrate how the hospital staff struggle for legitimacy after this policy change, and how cost savings obstructed the specialized department in achieving its goals.

Originality/value

The authors conclude that the usual economies-of-scales-based logic of (higher)volume-(better)outcome studies cannot easily be transferred to specialization in hospitals, unless one accounts for the institutional reason of the specialization.

Details

International Journal of Operations & Production Management, vol. 37 no. 7
Type: Research Article
ISSN: 0144-3577

Keywords

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