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Prolonged Length of Hospital Stay and Delayed Discharges Among Patients Referred to Child Psychiatry Liaison

Laura Bond1, Rushil Palavarapu2, Aoife Gordon1

  • 1Department of Child Psychiatry, School of Medicine, University College Dublin, Dublin, Ireland; Department of Paediatric Liaison Psychiatry, Children's Health Ireland, Dublin, Ireland.

The Journal of Pediatrics
|June 26, 2025
PubMed

Insights

Systemic barriers and complex patient needs prolong hospital stays for children needing psychiatric care. Improving collaboration and access to services is crucial for timely discharges and better outcomes.

Area of Science:

  • Child and Adolescent Psychiatry
  • Health Services Research
  • Pediatric Healthcare Management

Background:

  • Prolonged hospital stays and delayed discharges are significant issues in pediatric mental healthcare.
  • Pediatric Consultation-Liaison Psychiatry Services face challenges in managing complex cases.

Purpose of the Study:

  • To identify factors contributing to prolonged length of stay (LOS) and delayed discharges in children referred to psychiatric services.
  • To understand barriers to timely discharge for pediatric mental health patients.

Main Methods:

  • A 5-year retrospective chart review of patients with prolonged admissions (>30 days) and delayed discharges.
  • Semi-structured interviews with clinicians to gather perspectives on discharge barriers, followed by thematic analysis.

Main Results:

  • 107 patients met criteria for prolonged LOS, with delays often caused by systemic issues like limited psychiatric unit access and insufficient community support.
  • Patient factors, including eating disorders and neurodevelopmental conditions, also contributed to prolonged stays.
  • Clinician interviews revealed resource constraints and discharge planning challenges, leading to strained resources and delayed treatment.

Conclusions:

  • Improved interagency collaboration is needed to address systemic barriers.
  • Expanded access to psychiatric inpatient care and streamlined discharge pathways are essential.
  • Reducing inappropriate hospital stays will improve outcomes for pediatric patients with mental health needs.
Abstract

Keywords:
delayed dischargesliaisonprolonged admissionpsychiatry

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