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Assessing outcomes: identifying psychiatric patients with severe and persistent illness
J W Goethe1, E H Fischer, E A Dornelas
1Burlingame Center for Psychiatric Research and Education, Institute of Living, Hartford, USA.
Connecticut Medicine
|October 23, 1997
Summary
Psychiatric patients with low functioning at admission often experience long-term disability. Early identification using clinical measures can guide treatment and improve patient outcomes.
Area of Science:
- Psychiatry
- Clinical Psychology
- Health Services Research
Background:
- Identifying psychiatric patients with severe and persistent impairments is crucial for effective treatment and program planning.
- Accurate assessment aids in cost-of-care projections for mental health services.
Purpose of the Study:
- To assess the persistence of functional impairment in psychiatric inpatients.
- To determine the proportion of low-functioning patients who remain impaired at follow-up.
- To evaluate the utility of admission functional status measures for predicting long-term outcomes.
Main Methods:
- Prospective study of 1,679 psychiatric inpatients.
- Patients classified using a functional status measure upon admission.
- Follow-up assessments at discharge and 3, 6, and 12 months postdischarge.
Main Results:
- 23.4% of patients were classified as low functioning on admission.
- 56.1% to 65.2% of low-functioning patients remained impaired at follow-up.
- Low-functioning patients had a significantly higher rehospitalization rate (32%) compared to high-functioning patients (9.4%) within 12 months.
Conclusions:
- Commonly available clinical measures can identify psychiatric patients at risk for persisting disability.
- Over half of psychiatric inpatients with low functioning at admission experience long-term impairment.
- Early identification facilitates targeted interventions and resource allocation for improved patient care.
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