title: Physical characteristics of residential psychiatric and substance abuse programs: organizational determinants and patients outcomes.
abstract: Described the Physical and Architectural Characteristics Inventory (PACI), which assesses the physical characteristics of hospital- and community-based psychiatric and substance abuse residential treatment programs for adults. Developed using data from 94 representative programs, the PACI has 7 dimensions that assess community accessibility, physical features that add convenience, aid recreation, and provide support for patients, and space for patient and staff functions. In comparison to community-based programs (n = 63), hospital programs (n = 31) had more social-recreational and prosthetic aids, safety features, staff facilities, and space. The PACI dimensions were also related to other organizational features, such as facility ownership and program size and staffing level. Programs with more physical amenities had patients who were more involved in self-initiated and community activities and were more likely to successfully complete the program and be discharged to independent living situations and paid jobs. Programs with more social-recreational and prosthetic aids, space, and access to community resources also had better patient outcomes. In addition, PACI dimensions were related to observers' ratings of facility attractiveness. Potential applications of the PACI and the full inventory of which it is a part are discussed.
authors.affiliation: Center for Health Care Evaluation, Department of Veterans Affairs Medical Center, Palo Alto, California, USA.
authors.forename: C
authors.initials: C
authors.lastname: Timko
mesh_terms: D000328:Adult; D000437:Alcoholism / Q000523:psychology / Q000534:rehabilitation; D003688:Deinstitutionalization; D005160:Facility Design and Construction; D006297:Health Services Accessibility; D006801:Humans; D001523:Mental Disorders / Q000523:psychology / Q000534:rehabilitation*; D009042:Motivation; D010043:Outcome and Process Assessment, Health Care; D010348:Patient Care Team; D010555:Personality Inventory; D012112:Residential Facilities; D012495:San Francisco; D012931:Social Environment; D016320:Substance Abuse Treatment Centers; D019966:Substance-Related Disorders / Q000523:psychology / Q000534:rehabilitation*; D016896:Treatment Outcome