The relationship between depression and length of stay in the general hospital patient.

Abstract

BACKGROUND: Depression is believed to complicate the care of general hospital patients on medical and surgical wards. How to compare dissimilar medical disorders and the degree of illness has been problematic. METHOD: All patients evaluated during a 6-month period by one consultation-liaison service who received a DSM-III-R diagnosis of depression were retrospectively compared with a control group without any depressive symptoms who were admitted to the same medical-surgical units over the identical period of time. The two groups were matched by primary diagnostic related groups (DRGs) and had equivalent severity of illness scores (APACHE II). RESULTS: The depressed group had a mean length of stay 10 days longer than did the control group (t = 2.42, p < .02). Depressed patients who were treated with antidepressants and supportive therapy at the time of consultation by a psychiatrist (N = 15, 83%) had a mean length of stay 31.8 days shorter than those whose major depression was not treated (N = 3, 17%) (t = 2.19, p < .04). CONCLUSION: Matching depressed patients having a variety of physical illnesses to a nondepressed group having the same primary DRGs and equivalent severity of illness demonstrates the impact of comorbidity on length of stay and potential health care costs.

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