Hospital Length of Stay and Associated Factors in Adult Patients with Depression in Germany: A Cross-Sectional Study

doi:10.3390/jcm13154331

. 2024 Jul 25;13(15):4331.

doi: 10.3390/jcm13154331.

Hospital Length of Stay and Associated Factors in Adult Patients with Depression in Germany: A Cross-Sectional Study

Nimran Kaur¹, Marcel Konrad², André Hajek³, Lee Smith⁴, Karel Kostev^{5

6}

Affiliations

¹ Epidemiology, IQVIA, Bangalore 560 103, India.
² Department of Health and Social, FOM University of Applied Sciences for Economics and Management, 60486 Frankfurt am Main, Germany.
³ Department of Health Economics and Health Services Research, University Medical Center Hamburg-Eppendorf, Hamburg Center for Health Economics, 20246 Hamburg, Germany.
⁴ Centre for Health, Performance and Wellbeing, Anglia Ruskin University, Cambridge CB1 1PT, UK.
⁵ Epidemiology, IQVIA, Unterschweinstiege 2-14, 60549 Frankfurt am Main, Germany.
⁶ University Clinic, Philipps-University, 35043 Marburg, Germany.

PMID: 39124598
PMCID: PMC11313675
DOI: 10.3390/jcm13154331

Hospital Length of Stay and Associated Factors in Adult Patients with Depression in Germany: A Cross-Sectional Study

Nimran Kaur et al. J Clin Med. 2024.

. 2024 Jul 25;13(15):4331.

doi: 10.3390/jcm13154331.

Authors

Nimran Kaur¹, Marcel Konrad², André Hajek³, Lee Smith⁴, Karel Kostev^{5

6}

Affiliations

¹ Epidemiology, IQVIA, Bangalore 560 103, India.
² Department of Health and Social, FOM University of Applied Sciences for Economics and Management, 60486 Frankfurt am Main, Germany.
³ Department of Health Economics and Health Services Research, University Medical Center Hamburg-Eppendorf, Hamburg Center for Health Economics, 20246 Hamburg, Germany.
⁴ Centre for Health, Performance and Wellbeing, Anglia Ruskin University, Cambridge CB1 1PT, UK.
⁵ Epidemiology, IQVIA, Unterschweinstiege 2-14, 60549 Frankfurt am Main, Germany.
⁶ University Clinic, Philipps-University, 35043 Marburg, Germany.

PMID: 39124598
PMCID: PMC11313675
DOI: 10.3390/jcm13154331

Abstract

Objective: The aim of the present study was to evaluate the hospital length of stay (LoS) and its associated factors among adult patients hospitalized with depression in Germany. Methods: This cross-sectional study included all adults (≥18 years) hospitalized with depression from January 2019 to December 2023 treated in 36 hospitals across Germany. The primary outcome was patients' hospital LoS in days. The associations between age, sex, depression severity, co-diagnoses, hospital, and hospital LoS were analyzed using hierarchical multivariable linear regression models. Results: A total of 6579 patients (mean age 46.6 ± 17.7 years) with 8965 hospitalizations for depression were available. The mean hospital LoS was 35.2 days. Severe depression (+4.9 days) was associated with a longer hospital LoS, with moderate depression as the reference. Older age was positively associated with a longer hospital LoS. Vitamin D deficiency (+9 days), lipid metabolism disorders (+8 days), obesity (+8 days), sleep disorders (+7 days), and reaction to severe stress and adjustment disorders (+5 days) were also significantly associated with hospital LoS. Conclusions: In patients with depression, higher depression severity, advanced age, vitamin D deficiency, lipid metabolism disorders, obesity, sleep disorders, reactions to severe stress, and adjustment disorders were associated with a longer hospital LoS. Addressing these factors through comprehensive and integrated care strategies could help optimize hospitalization duration and improve overall patient outcomes.

Keywords: Germany; depression; hospital length of stay; hospitalization; obesity; sleep disorders; vitamin D deficiency.

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Conflict of interest statement

The authors have no conflicts of interest to declare.

Figures

**Figure 1**
Hospital length of stay by hospital.

**Figure 2**
Hospital length of stay in the overall population and by age, sex, and depression severity.

See this image and copyright information in PMC

References

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[1] Prina A.M., Cosco T.D., Dening T., Beekman A., Brayne C., Huisman M. The association between depressive symptoms in the community, non-psychiatric hospital admission and hospital outcomes: A systematic review. J. Psychosom. Res. 2014;78:25–33. doi: 10.1016/j.jpsychores.2014.11.002. - DOI - PMC - PubMed

[2] Prina A.M., Cosco T.D., Dening T., Beekman A., Brayne C., Huisman M. The association between depressive symptoms in the community, non-psychiatric hospital admission and hospital outcomes: A systematic review. J. Psychosom. Res. 2014;78:25–33. doi: 10.1016/j.jpsychores.2014.11.002. - DOI - PMC - PubMed

[3] Davydow D.S., Fenger-Grøn M., Ribe A.R., Pedersen H.S., Prior A., Vedsted P., Unützer J., Vestergaard M. Depression and risk of hospitalisations and rehospitalisations for ambulatory care-sensitive conditions in Denmark: A population-based cohort study. BMJ Open. 2015;5:e009878. doi: 10.1136/bmjopen-2015-009878. - DOI - PMC - PubMed

[4] Davydow D.S., Fenger-Grøn M., Ribe A.R., Pedersen H.S., Prior A., Vedsted P., Unützer J., Vestergaard M. Depression and risk of hospitalisations and rehospitalisations for ambulatory care-sensitive conditions in Denmark: A population-based cohort study. BMJ Open. 2015;5:e009878. doi: 10.1136/bmjopen-2015-009878. - DOI - PMC - PubMed

[5] Gialluisi A., Bracone F., Costanzo S., Santonastaso F., Di Castelnuovo A., Orlandi S., Magnacca S., De Curtis A., Cerletti C., Donati M.B., et al. Role of leukocytes, gender, and symptom domains in the influence of depression on hospitalization and mortality risk: Findings from the Moli-sani study. Front. Psychiatry. 2022;13:959171. doi: 10.3389/fpsyt.2022.959171. - DOI - PMC - PubMed

[6] Gialluisi A., Bracone F., Costanzo S., Santonastaso F., Di Castelnuovo A., Orlandi S., Magnacca S., De Curtis A., Cerletti C., Donati M.B., et al. Role of leukocytes, gender, and symptom domains in the influence of depression on hospitalization and mortality risk: Findings from the Moli-sani study. Front. Psychiatry. 2022;13:959171. doi: 10.3389/fpsyt.2022.959171. - DOI - PMC - PubMed

[7] [(accessed on 1 July 2024)]. Available online: https://psychiatryonline.org/doi/book/10.1176/appi.books.9780890425596. - DOI

[8] [(accessed on 1 July 2024)]. Available online: https://psychiatryonline.org/doi/book/10.1176/appi.books.9780890425596. - DOI

[9] Gialluisi A., Costanzo S., Di Castelnuovo A., Bonaccio M., Bracone F., Magnacca S., De Curtis A., Cerletti C., Donati M.B., de Gaetano G., et al. Combined influence of depression severity and low-grade inflammation on incident hospitalization and mortality risk in Italian adults. J. Affect. Disord. 2021;279:173–182. doi: 10.1016/j.jad.2020.10.004. - DOI - PubMed

[10] Gialluisi A., Costanzo S., Di Castelnuovo A., Bonaccio M., Bracone F., Magnacca S., De Curtis A., Cerletti C., Donati M.B., de Gaetano G., et al. Combined influence of depression severity and low-grade inflammation on incident hospitalization and mortality risk in Italian adults. J. Affect. Disord. 2021;279:173–182. doi: 10.1016/j.jad.2020.10.004. - DOI - PubMed

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Hospital Length of Stay and Associated Factors in Adult Patients with Depression in Germany: A Cross-Sectional Study

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Hospital Length of Stay and Associated Factors in Adult Patients with Depression in Germany: A Cross-Sectional Study

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