1. Measuring outcomes on a Medical Psychiatric Unit: HoNOS, CANSAS and costs
- Author
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Jan J. V. Busschbach, Luc Jansen, Jeroen G. Lijmer, F. Hunnik, and Psychiatry
- Subjects
Adult ,Male ,medicine.medical_specialty ,Psychiatric Department, Hospital ,Unmet needs ,Unit (housing) ,03 medical and health sciences ,0302 clinical medicine ,Cronbach's alpha ,Claims data ,Health care ,Outcome Assessment, Health Care ,Medicine ,Humans ,Prospective Studies ,Prospective cohort study ,Psychiatry ,Biological Psychiatry ,Aged ,Psychiatric Status Rating Scales ,business.industry ,Mental Disorders ,Health Care Costs ,Middle Aged ,030227 psychiatry ,Hospitalization ,Psychiatry and Mental health ,Observational study ,Functional status ,Female ,business ,030217 neurology & neurosurgery ,Needs Assessment - Abstract
Objective To study the course of the functional status and healthcare needs of patients on a Medical Psychiatric Unit (MPU). Methods In a single-centre observational prospective design the Health of the Nation Outcome Scales (HoNOS) and Camberwell Assessment of Needs Short Appraisal Schedule (CANSAS) instruments were administered at admission and discharge. Functional status and healthcare needs were assessed utilizing the HoNOS and CANSAS respectively. The total costs of healthcare claims related to the admission were calculated based on claims data. Results In total 50 patients were included with a mean improvement of 4.6 on the HoNOS and an effect size of 0.6.The total number of unmet needs fell from 208 to 115. The median costs per decreased HoNOS point were €2.842 and €6.880 per unmet need. Discussion Many patients improved, but due to a large standard deviation at baseline and a low Cronbach's alpha, only 4 patients showed a reliable improvement on functional status. That substantial remission was achieved was shown by the decrease in unmet needs of 93 (44.7%) for the whole group. These observations support the implementation of MPUs, although more research is warranted to ensure cost-effectiveness.
- Published
- 2019