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Barriers to discharge: A retrospective study of factors associated with stays of longer than 2 years in a French secure hospital unit

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  • Additional Information
    • Contributors:
      HAL UVSQ, Équipe; Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP); Centre de recherche en épidémiologie et santé des populations (CESP); Université de Versailles Saint-Quentin-en-Yvelines (UVSQ)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpital Paul Brousse-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université Paris-Saclay; Université Paris-Saclay; Université Paris Cité (UPCité); Institut National de la Santé et de la Recherche Médicale (INSERM)
    • Publication Information:
      Wiley, 2024.
    • Publication Date:
      2024
    • Abstract:
      BackgroundExtended stays in specialist secure hospital units raise ethical concerns. While this topic has been investigated in various countries, there has been little research on it in France.AimsWe aimed to study the length of stay of patients in the Henri Colin unit, a secure hospital unit in the Paris area and test relationships between length of stay and sociodemographic, clinical and legal features.MethodsIn this records‐based retrospective study, we included all 60 inpatients on a census day just prior to the pandemic. We chose a 2‐year threshold to define long stay status.ResultsMean length of stay was just in the long‐stay range (756.7 days, SD 1071.2). Over a quarter (17, 28%) of the patients had been hospitalised for more than 2 years and 5 (8%) patients for more than 5 years. In multivariate analysis, legal status and need for seclusion during stay were significantly associated with long‐stay status. These results are consistent with international literature, especially as they show the significant interplay between legal and medical aspects in the patients' care pathway.ConclusionAs the first such study in a specialist medium security hospital unit in France, this study adds to the international evidence on the complexities surrounding extended stays in secure units and underscores the importance of addressing both clinical and legal aspects in the treatment of patients with mental disorders in these settings.
    • File Description:
      application/pdf
    • ISSN:
      1471-2857
      0957-9664
    • Accession Number:
      10.1002/cbm.2359
    • Rights:
      CC BY NC ND
      URL: http://creativecommons.org/licenses/by-nc-nd/4.0/This is an open access article under the terms of the http://creativecommons.org/licenses/by-nc-nd/4.0/ (http://creativecommons.org/licenses/by-nc-nd/4.0/) License, which permits use and distribution in any medium, provided the original work is properly cited, the use is non‐commercial and no modifications or adaptations are made.
    • Accession Number:
      edsair.doi.dedup.....875f66f4fadf51780b358f679bb7b04e