Comparison of outcomes of acute care in short-term residential treatment and psychiatric hospital settings.

OBJECTIVE: The study compared the demographic and diagnostic characteristics of clients and the outcomes of treatment in five short-term acute residential treatment programs and two acute hospital-based psychiatric programs. METHODS: A total of 368 clients in the short-term acute residential treatment programs and 186 clients in the psychiatric hospital programs participated in an observational study. The study used a repeated-measures design and assessed participants on multiple standardized measures of symptoms and functioning at admission, discharge, and four-month follow-up. Comparisons between the two groups were conducted separately by diagnostic category. Measures included the Brief Symptom Inventory, the Behavior and Symptom Identification Scale-32, the Medical Outcomes Short-Form-36, and the Client Satisfaction Questionnaire-8. RESULTS: The two types of programs admit persons with similar levels of acute distress who have comparable levels of improvement at discharge and an equivalent degree of short-term stability of treatment gains. Costs of treatment episodes were considerably lower for the short-term residential programs, and client satisfaction with the two types of programs was comparable. CONCLUSIONS: Short-term acute residential treatment is a less costly yet similarly effective alternative to psychiatric hospitalization for many voluntary adult patients.

A treatment outcome study of community-based residential care.

OBJECTIVE: The authors describe two psychosocially oriented community residential facilities for patients with persistent and severe mental disorders and multiple failures at community tenure, and they report a retrospective study designed to evaluate treatment outcomes of program residents. METHODS: The study employed a retrospective single-group repeated-measures design to evaluate 104 patients who completed the one-year follow-up. One-year mean number of admissions to and days in a hospital or crisis center during the two years before program entry were compared with mean admissions and days for the follow-up year; employment status, living status, and Global Assessment of Functioning (GAF) Scale scores at program entry and at one-year follow-up were also compared. Thirteen sociodemographic and clinical variables were individually tested for association with outcome. RESULTS: Hospital and crisis center admissions and days were significantly reduced during the follow-up year. At one-year follow-up, a significantly greater proportion of patients were employed and living independently, and fewer were homeless. GAF scores were significantly higher. No significant correlations between outcome and sociodemographic and clinical variables were found. CONCLUSIONS: Despite design limitations of the study, the findings suggest that psychosocial residential treatment models can offer cost-effective and clinically efficacious care to persistently mentally ill patients.