Evaluation of severe and chronic factors for extended stays in Japanese Medical Treatment and Supervision Act wards

Naoya Takeda^1*Hiroko Kashiwagi¹Norio Watanabe²Hirabaya Naotsugu¹

• ¹National Center of Neurology and Psychiatry (Japan), Kodaira, Japan
• ²Kyoto University Department of Plastic and Reconstructive Surgery, Kyoto, Japan

Objective: The Japanese Ministry of Health, Labour and Welfare introduced the "severe and chronic" criteria to describe conditions associated with long-term psychiatric hospitalization. This study examined factors contributing to prolonged hospitalization in Medical Treatment and Supervision (MTS) Act wards using these criteria. Methods: The "severe and chronic" criteria comprise three components: "Psychiatric symptoms," "Behavioral disorders," and "Life disorders". As of January 10, 2014, 210 patients hospitalized in MTS Act wards for 1.5 years were enrolled. Treatment outcomes were assessed at 1.5, 2.5, and 3.5 years, and associations between hospitalization duration and each criterion were analyzed. Results: By 3.5 years, 185 patients had been discharged. At this timepoint, "Psychiatric symptoms" and "Life disorders" were significantly associated with hospitalization outcomes. Twenty individual items—primarily subitems of "Psychiatric symptoms" and "Life disorders"— were consistently related to hospitalization at all timepoints (p < 0.05). Conclusions: The "Psychiatric symptoms" and "Life disorders" components of the "severe and chronic" criteria were significantly associated with hospitalization outcomes in MTS Act wards.