Paths and Gates: The Sources of Recidivism and Length of Stay on a Psychiatric Ward

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Abstract
Four "pathway" (age, sex, social class, and number of dependents) and three "gatekeeper" (previous admission, previous ward terms, and severity of patient disorder) variables are used to predict recidivism rates and lengths of stay for patients admitted to a psychiatric ward in a general hospital during a 1-year period. There were three major findings. First, the gatekeeper variables were, by themselves, useful for predicting length of stay; additional information, in the form of the pathway variables, was needed to adequately explain differences in recidivism. Second, while most of the effects on recidivism were direct, most of the effects on length of stay were indirect or mediated through the variable of the severity of patient problems. Third, it was discovered that recidivism and length of stay are inversely related: patients with high recidivism rates, for example, tend to have relatively short average lengths of stay. Based on four patterns of recidivism and length of stay, a typology was developed to facilitate a better understanding of patient behavior.

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