Routine 'Health of the Nation Outcome Scales for elderly people' (HoNOS65+) collection in an acute psychogeriatric inpatient unit in New Zealand.
BACKGROUND
HoNOS (Health of the Nation Outcomes Scale) is an outcome measure used by mental health professionals aiming to give a snapshot of a person's psychiatric symptoms and psychosocial functioning.


OBJECTIVE
HoNOS65+ was introduced as a routine outcome measure in our service as part of the New Zealand Mental Health Standard Measures of Assessment and Recovery Outcomes Initiative. The aim of this paper is to report the findings from the use of this tool in our acute psychogeriatric inpatient unit.


METHODS
This is a retrospective analysis of the HoNOS database from 2002 to 2005. Service users were classified into two groups (organic disorders and functional disorders) according to their ICD-10 clinical coding diagnoses. Statistical analysis was performed to compare the HoNOS65+ scores at admission and discharge within each group.


RESULTS
There were 431 start episodes and 452 end episodes completed. However, only 130 of these episodes were matched and were usable in this analysis. 29(21%) service users with diagnoses of organic disorders and 101(72%) with diagnoses of functional disorders. The mean total HoNOS65+ score reduced significantly for both groups from admission (organic: 16.45; functional: 14.00) to discharge (organic: 12.34; functional: 8.76). For the organic group, significant improvement was observed in 2 (behaviour and symptoms) subscales; and for the functional group, significant improvement was observed in 3 (behaviour, impairment, and symptoms) subscales.


CONCLUSIONS
The findings provide objective evidence to support the clinical impression that psychogeriatric inpatient treatment is an effective intervention for both organic and functional disorders. We identified a lack of improvement in the social subscale for both groups. The social subscale scores on admission were relatively low and the lack of improvement might be because specific interventions were not necessary during the inpatient episode. Further exploration of this subscale would be useful in clarifying whether there is a need to plan service development to address these aspects of service users' care during the acute admission phase.
Cheung
Gary
G
Mental Health Services for Older People, Health Waikato, PO Box 1372, Hamilton. cheungg@waikatodhb.govt.nz.
Strachan
John
J
D000368:Aged; D000369:Aged, 80 and over; D019992:Databases as Topic; D005260:Female; D005852:Geriatric Psychiatry / Q000592:standards*; D006757:Hospital Units / Q000592:standards*; D006801:Humans; D008297:Male; D008485:Medical Audit; D001523:Mental Disorders / Q000453:epidemiology* / Q000523:psychology*; D009520:New Zealand / Q000453:epidemiology; D017063:Outcome Assessment, Health Care / Q000706:statistics & numerical data*; D011567:Psychiatric Department, Hospital / Q000592:standards*; D019984:Quality Indicators, Health Care; D012189:Retrospective Studies