The Effects of State Psychiatric Hospital Waitlist Policies on Length of Stay and Time to Readmission

Elizabeth Holdsworth La, Ruoqing Zhu, Kristen Hassmiller Lich, Alan R. Ellis, Marvin S. Swartz, Michael R. Kosorok, Joseph P. Morrissey

Research output: Contribution to journalArticlepeer-review


This study examined the effects of a waitlist policy for state psychiatric hospitals on length of stay and time to readmission using data from North Carolina for 2004–2010. Cox proportional hazards models tested the hypothesis that patients were discharged “quicker-but-sicker” post-waitlist, as hospitals struggled to manage admission delays and quickly admit waitlisted patients. Results refute this hypothesis, indicating that waitlists were associated with increased length of stay and time to readmission. Further research is needed to evaluate patients’ clinical outcomes directly and to examine the impact of state hospital waitlists in other areas, such as state hospital case mix, local emergency departments, and outpatient mental health agencies.

Original languageEnglish (US)
Pages (from-to)332-342
Number of pages11
JournalAdministration and Policy in Mental Health and Mental Health Services Research
Issue number3
StatePublished - May 1 2015
Externally publishedYes


  • Patterns of utilization
  • Policy analysis
  • State psychiatric hospitals
  • Waitlist

ASJC Scopus subject areas

  • Phychiatric Mental Health
  • Health Policy
  • Public Health, Environmental and Occupational Health
  • Psychiatry and Mental health


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