A cluster analytic study of functional outcome after psychiatric hospitalization

We report the initial results from a prospective study designed to assess patients' functional outcome and level of service utilization following psychiatric hospitalization. All patients admitted between March 31, 1993 and April 1, 1994 were interviewed at admission and discharge, and 350 consenting patients were reassessed 3 months postdischarge. Subgroups were created using cluster analysis (measures of outcome were rehospitalization, self-rated productivity and functioning, and satisfaction with living situation and employment/daily activities at the 3-month follow-up study), and these clusters were then validated using other variables. Four distinct outcome categories were identified. Cluster I contained patients with the greatest functional impairment and the highest rate of rehospitalization (28%). Cluster IV patients reported superior functioning and satisfaction and the lowest rate of rehospitalization (8%). Clusters II and III had intermediate outcomes, the first characterized by greater satisfaction with living situation, and the other by higher ratings for functioning and productivity. Outcome data are important to providers for program evaluation and patient care; if replicated in other samples, the four outcome categories reported may be useful for national mental health care policy and planning.