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Patient characteristics and outcome measurement in a low secure forensic hospital
Author(s) -
Longdon Laura,
Edworthy Rachel,
Resnick Jeremy,
Byrne Adrian,
Clarke Martin,
Cheung Natalie,
Khalifa Najat
Publication year - 2018
Publication title -
criminal behaviour and mental health
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.63
H-Index - 54
eISSN - 1471-2857
pISSN - 0957-9664
DOI - 10.1002/cbm.2062
Subject(s) - bonferroni correction , medicine , scale (ratio) , public health , referral , gerontology , psychiatry , family medicine , demography , nursing , statistics , physics , mathematics , quantum mechanics , sociology
Background Health services are increasingly required to measure outcomes after treatment, which can be reported to the funding body and may be scrutinised by the public. Extensive high‐quality measurements are time consuming. Routinely collected clinical data might, if anonymised, provide good enough evidence of useful change consequent on service received. Research question Do the Health of the Nation Scale and the 20‐item Historical, Clinical, Risk structured professional judgement tool scores provide evidence of clinical and risk change among low security hospital patients at 6 and 12 months after admission? Methods One hundred and eight men were either resident on the unit on 1 January 2011 or new admissions to the census date of 31 May 2013. Their routinely collected data were added to an outcome register following each patient's Care Programme Approach clinical review meeting and analysed using repeated measures t‐tests with Bonferroni corrections. Results Most of the men, mean age 34.3 years, were single (93%), White British (71%) and with a primary diagnosis of schizophrenia (62%). There were significant reductions in the 11‐item Health of the Nation Scale (excluding the community living condition scale) scores between baseline and 6 months and between 6 and 12 months, but no change on its additional 7‐item secure subscale. Individual effect sizes indicated that 39% of the men had better social function, although 18% had deteriorated at 6 months. There was little overall change in the 20‐item Historical, Clinical, Risk; individual effect sizes indicated that 11 men (15%) were rated as being at lower risk level and 10 (14%) at higher after 6 months in the study. Conclusions/implications for clinical practice Standard clinical measures are promising as indicators of change in low security hospital patients. Risk ratings may be conservative, but at this stage of a secure hospital admission, higher scores may be as likely to indicate progress in identifying and quantifying risks as apparent increase in risk. Copyright © 2017 John Wiley & Sons, Ltd.