The effects of an outcome measurement program on hospitalization of adults with severe mental illness

Managed care presents multiple challenges to public mental health agencies. One challenge is developing a method for demonstrating clinical and fiscal effectiveness. Outcome measurement is a useful and practical method for proving clinical effectiveness. This study describes one agency's outcome measurement program and examines its effectiveness in reducing utilization of expensive services. Hospitalization and emergency psychiatric services are the most costly psychiatric services. Integrating outcome targets for reduction of costly services in an outcome measurement program is an effective method for decreasing these costs.;Research study subjects were 138 adults with severe mental illness who received case management services. Observations were made in increments for two years prior to the implementation of the outcome measurement program and three and half years following it. Three hypotheses were studied: (1) reduction of hospitalization was tested using an ARIMA model of time series and a split middle method of trend estimation; (2) the periods of time between hospitalization were tested using a method for testing against trend and (3) a split middle method of trend estimation was applied to utilization of psychiatric emergency services.;Results indicated that implementation of the outcome measurement program lead to a statistically significant reduction in rate of hospitalization. Second, the periods of time between hospitalizations lengthened. Finally, the rate of psychiatric emergency services decreased. Overall, the research study was instrumental in supporting the use of outcome measurement programs in preparation for managed care and demonstrated its effectiveness in managing utilization of high cost psychiatric services. Implications for future research and clinical practice are provided.