Abstract
A sample of 126 consecutively admitted residential treatment children (mean age = 9.86, SD=1.84; 70.6% male; 42.1% African American; 50% Caucasian) were studied over a five-year period to identify predictors of length-of-stay. Cox regression was the primary statistical method used to analyze psychiatric and behavioral rating data for children assessed by teachers and treatment staff using the Devereux Scales of Mental Disorders (DSMD). Parental alcohol abuse, and children’s age, medication status, race, initial DSMD total and critical pathology scores, were predictive of length-of-stay. Residential length-of-stay was strongly linked to initial levels of psychiatric symptomatology. Models that can help forecast length of stay are vital tools in helping to improve both clinical and utilization management strategies.
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References
HB Clark B Lee ME Prange BA McDonald (1996) ArticleTitleChildren lost within the foster care system: Can wraparound service strategies improve placement outcomes? J Child Fam Stud 5 39–54
AJ Duchnowski RM Friedman (1990) ArticleTitleChildren’s mental health: Challenges for the nineties J Ment Health Admin 17 3–12
J Knitzer S Yelton (1990) ArticleTitleCollaboration between child welfare and mental health: Both systems must exploit the program possibilities Public Welfare 48 24–33
AA Rosenfeld DJ Pilowsky P Fine M Thorpe E Fein MD Simms N Halfon M Irwin J Alfaro R Saletsky S Nickman (1997) ArticleTitleFoster care: An update J Am Acad Child Psy 36 448–458 Occurrence Handle10.1097/00004583-199704000-00006
R Small K Kennedy B Bender (1991) ArticleTitleCritical issues for practice in residential treatment: The view from within Am J Orthopsychiat 61 IssueID3 327–338 Occurrence Handle1951640
U.S. Government Accounting Office, Department of Health & Human Services. Child Welfare: Complex needs Strain Capacity to Provide Services. GAO/HEHS-95–208. Washington, DC: Government Printing Office, 1995.
Courtney M: Factors associated with entrance into group care. In: Child welfare research review Vol 1. eds. Barth RP, Berrick JD, Gilbert N. New York: Columbia University Press, 1994.
K Wells (1991) ArticleTitlePlacement of emotionally disturbed children in residential treatment: A review of placement criteria Am J Orthopsychiat 61 IssueID3 339–347 Occurrence Handle1951641
JF Teare RE Larzelere GL Smith CY Becker LM Castrianno RW Peterson (1999) ArticleTitlePlacement stability following short-term residential care J Child Fam Stud 8 IssueID1 59–69 Occurrence Handle10.1023/A:1022946627782
JR Asarnow W Aoki S Elson (1996) ArticleTitleChildren in residential treatment: A follow-up study J Clin Child Psychol 25 IssueID2 209–214
SW Henggeler SK Schoenwald CM Borduin MD Rowland S Kashubeck SM Pottebaum NO Read (1994) ArticleTitlePredicting elopement from residential treatment centers Am J Orthopsychiat 64 126–135 Occurrence Handle8147421
PA Susneri (2003) ArticleTitlePredicting treatment termination due to running away among adolescents in residential care Resident Treat Child Yth 21 IssueID2 43–60 Occurrence Handle10.1300/J007v21n02_03
JS Lyons LN Libman-Mintzer CL Kisiel H Shallcross (1998) ArticleTitleUnderstanding the mental health needs of children and adolescents in residential treatment Prof Psychol-Res Pr 29 IssueID6 582–587 Occurrence Handle10.1037//0735-7028.29.6.582
DM Day A Paul K Goldberg (1994) ArticleTitleAssessing the post-residential functioning of latency aged conduct disordered children Resident Treat Child Yth 11 IssueID3 45–61
D Hussey S Guo (2002) ArticleTitleProfile characteristics and behavioral change trajectories of young residential children J Child Fam Stud 11 IssueID4 401–410 Occurrence Handle10.1023/A:1020927223517
JS Lyons P Terry Z Martinovich J Peterson B Bouska (2001) ArticleTitleOutcome trajectories for adolescents in residential treatment: A statewide evaluation J Child Fam Stud 10 IssueID3 333–345 Occurrence Handle10.1023/A:1012576826136
SI Pfeiffer S Strzelecki (1990) ArticleTitleInpatient psychiatric treatment of children and adolescents: A review of outcome studies J Am Acad Child Psy 29 IssueID6 847–853
L Bickman PR Guthrie EM Foster EW Lambert (1996) ArticleTitleWho gets hospitalized in a continuum of care? J Am Acad Child Psy 35 74–80 Occurrence Handle10.1097/00004583-199601000-00016
MM Dore AN Wilkinson WA Sonis (1992) ArticleTitleExploring the relationship between a continuum of care and restrictiveness of children’s mental health services Hosp Community Psych 43 44–48
LM Bullock EL Zagar CA Donahue GB Pelton (1985) ArticleTitleTeacher’s perceptions of behaviorally disordered students in a variety of settings Except Children 52 123–130
J Hundert JRB Cassie N Johnston (1988) ArticleTitleCharacteristics of emotionally disturbed children referred to day-treatment, special-class, outpatient, and assessment services J Clin Child Psychol 17 121–130
SG Zimet GK Farley GD Zimet (1994) ArticleTitleHome behaviors of children in three treatment settings: An outpatient clinic, a day hospital, and an inpatient hospital J Am Acad Child Psy 33 56–59
PC Friman J Evans R Larzelere G Williams DL Daly (1993) ArticleTitleCorrespondence between child dysfunction and program intrusion: Evidence of a continuum of care across five child mental health programs J Community Psychol 21 227–233
MI Handwerk PC Friman MA Mott JM Stairs (1998) ArticleTitleThe relationship between program restrictiveness and youth behavior problems J Emot Behav Disord 6 IssueID3 170–180
D Hopko D Lachar S Bailley R Varner (2001) ArticleTitleAssessing predictive factors for extended hospitalization at acute psychiatric admission Psychiat Serv 52 IssueID10 1367–1373 Occurrence Handle10.1176/appi.ps.52.10.1367
G Jayaram A Tien P Sullivan H Gwon (1996) ArticleTitleElements of a successful short, inpatient psychiatric service Psychiat Serv 47 IssueID4 407–412
J English S Sharfstein D Scherl B Astrachan I Musznski (1986) ArticleTitleDiagnosis related groups and general hospital psychiatry: The APA study Am J Psychiat 143 131–139 Occurrence Handle3080906
MA Blais J Matthews R Lipkis-Orlando E Lechner M Jacobo R Lincoln C Gulliver JB Herman AF Goodman (2003) ArticleTitlePredicting length of stay on an acute care medical psychiatric inpatient service Adm Policy Ment Hlth 31 IssueID1 15–29 Occurrence Handle10.1023/A:1026044106172
D Huntly D Cho J Christman J Csernansky (1998) ArticleTitlePredicting length of hospital stay in an acute psychiatric hospital Psychiat Serv 49 IssueID8 1049–1053
J Whittaker (2000) ArticleTitleReinventing residential childcare: An agenda for research and practice Resident Treat Child Yth 17 IssueID3 13–20 Occurrence Handle10.1300/J007v17n03_04
D Davis L Boster (1992) ArticleTitleCognitive-behavioral expressive interventions with aggressive and resistant youths Child Welfare 71 IssueID6 557–573 Occurrence Handle1424948
K Wells D Whittington (1993) ArticleTitleCharacteristics of youths referred to residential treatment: Implications for program design Child Youth Serv Rev 15 IssueID3 195–217 Occurrence Handle10.1016/0190-7409(93)90003-R
U.S. Department of Health and Human Services: The AFCARS Report, Administration for Children and Families, Administration on Children, Youth and Families, Children’s Bureau, www.acf.hhs.gov/programs/cb, 2002, August interim estimates.
Child Welfare League of America: Residential Group Care. http://www.cwla.org/programs/groupcare. 2002.
R Bess J Leos-Urbel R Geen (2001) The Cost of Protecting Vulnerable Children II: What has Changed since 1996? The Urban Institute Washington, DC
CW Lecroy JB Ashford (1992) ArticleTitleChildren’s mental health: Current findings and research directions Soc Work Res Abstr 28 13–30 Occurrence Handle10117363
MI Benedict RB White (1991) ArticleTitleFactors associated with foster care length of stay Child Welfare 70 IssueID1 45–58 Occurrence Handle1997291
ME Courtney YLI Wong (1996) ArticleTitleComparing the timing of exits from substitute care Child Youth Serv Rev 18 207–218
M Kupsinel D Dubsky (1999) ArticleTitleBehaviorally impaired children in out-of-home care Child Welfare 78 IssueID2 297–310 Occurrence Handle10418119
SL McMurtry GW Lie (1992) ArticleTitleDifferential exit rates of minority children in foster care Soc Work Res Abstr 28 IssueID1 42–48
C Vogel (1999) ArticleTitleUsing administrative databases to examine factors affecting length of stay in substitute care Child Youth Serv Rev 21 677–690 Occurrence Handle10.1016/S0190-7409(99)00046-8
J Naglieri P LeBuffe SI Pfeiffer (1994) Devereux Scales of Mental Disorders The Psychological Corporation San Antonio, TX
InstitutionalAuthorNameAmerican Psychiatric Association (1994) Diagnostic and Statistical Manual of Mental Disorders EditionNumber4 Author Washington, DC
J Lawless (1982) Statistical Models and Methods for Lifetime Data Wiley New York
N Tuma M Hannan (1984) Social Dynamics: Models and Methods Academic Press Orlando, Fl
P Allison (1995) Survival Analysis Using the SAS System: A Practical Guide SAS Institute NC
InstitutionalAuthorNameSAS (1997) The SAS System SAS Institute Cary NC
DF Connor KR Ozbayrak KA Kusiak AB Caponi RH Melloni (1997) ArticleTitleCombined pharmacotherapy in children and adolescents in a residential treatment center J Am Acad Child Psy 36 IssueID2 248–254 Occurrence Handle10.1097/00004583-199702000-00016
JM Zito DJ Safer S dosReis JF Gardener M Boles F Lynch (2000) ArticleTitleTrends in the prescribing of psychotropic medications to youngsters J Amer Med Assoc 283 1025–1060 Occurrence Handle10.1001/jama.283.8.1025
JM Zito TJ Craig J Wanderling (1994) ArticleTitlePharmacoepidemiology of 330 child/adolescent psychiatric patients J Pharmacoepidemiol 3 47–62
PA Curtis G Alexander LA Lunghofer (2001) ArticleTitleA literature review comparing the outcomes of residential group care and therapeutic foster care Child Adol Soc Work J 18 IssueID5 377–392 Occurrence Handle10.1023/A:1012507407702
K Hoagwood M Cunningham (1992) ArticleTitleOutcomes of children with emotional disturbance in residential treatment for educational purposes J Child Fam Stud 1 IssueID2 129–140 Occurrence Handle10.1007/BF01321281
R Dalton MA Forman GC Daul D Bolding (1987) ArticleTitlePsychiatric hospitalization of preschool children: Admission factors and discharge implications J Am Acad Child Psy 26 308–312
BJ Rice J Woolston E Stewart BD Kerker SM Horowitz (2002) ArticleTitleDifferences in younger middle, and older children admitted to child psychiatric inpatient services Child Psychiat Hum Develpm 32 IssueID4 241–261 Occurrence Handle10.1023/A:1015244626238
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This research supported by a grant from the Ohio Department of Mental Health
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Hussey, D.L., Guo, S. Forecasting Length of Stay in Child Residential Treatment. Child Psychiatry Hum Dev 36, 95–111 (2005). https://doi.org/10.1007/s10578-004-3490-9
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DOI: https://doi.org/10.1007/s10578-004-3490-9