Efrat Shadmi1, Marc Gelkopf2, Paula Garber-Epstein3, Vered Baloush-Kleinman4, Ronit Doudai4, David Roe2. 1. The Cheryl Spencer Department of Nursing, University of Haifa, Mount Carmel 31905, Israel; Center for Community Mental Health, Research, Practice and Policy, Faculty of Social Welfare and Health Sciences, University of Haifa, Mount Carmel 31905, Israel. Electronic address: eshadmi@univ.haifa.ac.il. 2. Center for Community Mental Health, Research, Practice and Policy, Faculty of Social Welfare and Health Sciences, University of Haifa, Mount Carmel 31905, Israel; Department of Community Mental Health, Faculty of Social Welfare and Health Sciences, University of Haifa, Mount Carmel 31905, Israel. 3. Center for Community Mental Health, Research, Practice and Policy, Faculty of Social Welfare and Health Sciences, University of Haifa, Mount Carmel 31905, Israel. 4. Department of Rehabilitation, Mental Health Services, Ministry of Health, Jerusalem, Israel.
Abstract
OBJECTIVE: Patient reported outcome measures (PROMs) are increasingly used to measure psychiatric service consumers' progress and to provide feedback to consumers and providers. We tested whether PROMs can predict and be used to identify groups at high risk for future hospitalization. METHODS: A total of 2842 Israeli users of psychiatric rehabilitation services reported on their quality of life (QoL) and the effect of symptoms on their daily functioning. Survey data were linked with information on psychiatric hospitalization 6 and 12months after survey completion. Variables associated with each of the outcomes were tested for significance and entered into a multivariate logistic regression model. Prediction scores were developed to identify the highest-risk groups according to each model. RESULTS: QoL was found to be a significant predictor of future hospitalization within 6months (odds ratio [OR]=0.71, 95% CI: 0.59-0.86), and self-report of the impact of symptoms on functioning significantly predicted 12-month hospitalization (OR=0.83, 95% CI: 0.74-0.93), controlling for known risk factors. Positive predictive values for the 6- and 12-month risk scores were 31.1 and 40.4, respectively, for the 10% highest risk categories. CONCLUSIONS: Reports of psychiatric service consumers on their QoL and on the effect of symptoms on their functioning significantly predict of future hospitalization risk, beyond other well-known risk factors. PROMs can identify consumers at high risk for future hospitalization and thus direct interventions for those at highest risk.
OBJECTIVE:Patient reported outcome measures (PROMs) are increasingly used to measure psychiatric service consumers' progress and to provide feedback to consumers and providers. We tested whether PROMs can predict and be used to identify groups at high risk for future hospitalization. METHODS: A total of 2842 Israeli users of psychiatric rehabilitation services reported on their quality of life (QoL) and the effect of symptoms on their daily functioning. Survey data were linked with information on psychiatric hospitalization 6 and 12months after survey completion. Variables associated with each of the outcomes were tested for significance and entered into a multivariate logistic regression model. Prediction scores were developed to identify the highest-risk groups according to each model. RESULTS: QoL was found to be a significant predictor of future hospitalization within 6months (odds ratio [OR]=0.71, 95% CI: 0.59-0.86), and self-report of the impact of symptoms on functioning significantly predicted 12-month hospitalization (OR=0.83, 95% CI: 0.74-0.93), controlling for known risk factors. Positive predictive values for the 6- and 12-month risk scores were 31.1 and 40.4, respectively, for the 10% highest risk categories. CONCLUSIONS: Reports of psychiatric service consumers on their QoL and on the effect of symptoms on their functioning significantly predict of future hospitalization risk, beyond other well-known risk factors. PROMs can identify consumers at high risk for future hospitalization and thus direct interventions for those at highest risk.