Consistency of the Health of the Nation Outcome Scales (HoNOS) at inpatient-to-community transition.
OBJECTIVE
The Health of the Nation Outcome Scales (HoNOS) are mandated outcome-measures in many mental-health jurisdictions. When HoNOS are used in different care settings, it is important to assess if setting specific bias exists. This article examines the consistency of HoNOS in a sample of psychiatric patients transitioned from acute inpatient care and community centres.


METHODS
A regional mental health service with both acute and community facilities.


METHODS
111 psychiatric patients were transferred from inpatient care to community care from 2012 to 2014. Their HoNOS scores were extracted from a clinical database; Each inpatient-discharge assessment was followed by a community-intake assessment, with the median period between assessments being 4 days (range 0-14). Assessor experience and professional background were recorded.


METHODS
The difference of HoNOS at inpatient-discharge and community-intake were assessed with Pearson correlation, Cohen's κ and effect size.


RESULTS
Inpatient-discharge HoNOS was on average lower than community-intake HoNOS. The average HoNOS was 8.05 at discharge (median 7, range 1-22), and 12.16 at intake (median 12, range 1-25), an average increase of 4.11 (SD 6.97). Pearson correlation between two total scores was 0.073 (95% CI -0.095 to 0.238) and Cohen's κ was 0.02 (95% CI -0.02 to 0.06). Differences did not appear to depend on assessor experience or professional background.


CONCLUSIONS
Systematic change in the HoNOS occurs at inpatient-to-community transition. Some caution should be exercised in making direct comparisons between inpatient HoNOS and community HoNOS scores.
School of Information Technology, Deakin University, Geelong, Victoria, Australia.
Wei
http://orcid.org/0000-0002-4711-7543
W
Luo
Mental Health Services, Barwon Health, School of Medicine, Deakin University, Geelong, Victoria, Australia.
Richard
R
Harvey
Centre for Pattern Recognition and Data Analytics, Deakin University, Australia, Geelong, Victoria, Australia.
Truyen
http://orcid.org/0000-0001-6531-8907
T
Tran
Centre for Pattern Recognition and Data Analytics, Deakin University, Australia, Geelong, Victoria, Australia.
Dinh
D
Phung
Centre for Pattern Recognition and Data Analytics, Deakin University, Australia, Geelong, Victoria, Australia.
Svetha
S
Venkatesh
Discipline of Psychiatry and Centre for Youth Substance Abuse Research, The University of Queensland, Brisbane, Queensland, Australia.
Jason P
JP
Connor
D000328:Adult; D015982:Bias; D003155:Community Mental Health Centers; D003266:Continuity of Patient Care; D005260:Female; D006760:Hospitalization; D006761:Hospitals; D006801:Humans; D007297:Inpatients; D008297:Male; D001523:Mental Disorders / Q000628:therapy*; D008605:Mental Health Services; D008875:Middle Aged; D017063:Outcome Assessment, Health Care / Q000379:methods / Q000592:standards*; D010351:Patient Discharge; D011569:Psychiatric Status Rating Scales / Q000592:standards*; D011594:Psychometrics; D012111:Residence Characteristics
Assessment; HoNOS; MENTAL HEALTH