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Measuring outcomes on a Medical Psychiatric Unit: HoNOS,, CANSAS and costs
L Jansen1, F Hunnik2, J J V Busschbach3
1Erasmus MC - Deparment of Psychiatry, University Hospital located in Rotterdam, the Netherlands; DC Klinieken - Chain of Private Clinics, staff is situated in Almere, the Netherlands.
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.
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