The nation's psychiatric hospitals are attracting more outpatient and partial hospitalization business, but remain heavily dependent on inpatient services for revenues.
Those conclusions were included in the National Association of Psychiatric Health Systems' 1993 survey, which was released last week. The annual survey revealed continuing reductions in the size of the psychiatric hospital business and more services moving to outpatient settings. The group represents 281 psychiatric systems, which are primarily private, hospital-based systems.
NAPHS reported that the number of inpatient days dropped 31% to 5.7 million in 1993. The drop reflects hospital closures and pressure from payers to discharge patients sooner or avoid inpatient stays altogether.
Compared with 1992 data, inpatient lengths of stay dropped 11% to 17.8 days, and occupancy levels dropped 10% to 57.9%, NAPHS said.
Outpatient and partial hospitalization admissions grew, according to the Washington-based group. Those admissions made up 20% of all admissions to psychiatric health systems in 1993, twice the percentage of the previous year.
However, that growth didn't seem to have much of an impact on the hospital systems' revenues. The systems reported deriving 89% of their revenues from hospital inpatient services, up from 88% in 1992. Only 7.7% of the systems' revenues came from outpatient and partial programs in 1993, down slightly from 8.2% in the previous year.
Mark Covall, the group's director of legislative and regulatory affairs, said he believes the latter percentage is changing quickly, however, and that this year, the percentage of revenues from outpatient and partial programs could double to 15% for psychiatric systems.
In contrast, acute-care hospitals receive about one-third of their revenues from outpatient services, according to HCIA, a Baltimore-based healthcare information company.
NAPHS also said the average psychiatric hospital had operating costs of $15 million, a 12% drop over the previous year.
Room and board rates for adults, which may include some physician services, rose 4% to $745 in 1993, the group said.
The tumultuous years of psychiatric hospital scandals and restructuring that took their toll on hospital administrators' jobs may be easing, however. The group reported an 8% turnover rate among psychiatric hospital administrators in 1993, compared with 31% in 1992 and 26% in 1991.