Do the Health of the Nation Outcome Scales Measure Outcome?

Kisely, S.; Campbell, Leslie Anne; Cartwright, Julia; Cox, Martha; Campbell, John H.

doi:10.1177/070674371005500706

Cited by 34 publications

(23 citation statements)

References 20 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Prevalence increased steadily to middle age, declining in the 50s and 60s, and then increasing again after age 70. These demographic and clinical features are similar to those in the few published Canadian studies on the routine use of standardized measures of mental health outcomes (Kisely et al, 2007(Kisely et al, , 2008(Kisely et al, , 2010.…”

Section: Demographic and Diagnostic Characteristics Of The Populationsupporting

confidence: 71%

Routine outcome measures in Canada

Kisely

Adair

Lin

et al. 2015

International Review of Psychiatry

View full text Add to dashboard Cite

Canada is a federal country of 10 provinces and three territories. High level information on mental health conditions and service use has mostly been generated from administrative data collected by provinces and territories. These include four major types - hospital admissions and discharges, physician billings, ambulatory care services, and drug databases. At the national level, the Canadian Institute for Health Information brings together this information to produce indicators of outcome. Although these data provide information on patient and health system characteristics, they do not capture the full spectrum of formal and informal mental healthcare. These include changes in health status, functioning, community integration and quality of life. As a result, some jurisdictions have begun to implement more standardized measures of outcome such as the clinician-rated Health of the Nation Outcome Scales or the inpatient Resident Assessment Instrument - Mental Health. In this paper we provide an overview of mental-health-related data sources in Canada, highlight some of the more progressive practices beginning to emerge, and conclude with some thoughts about how the routine measurement and reporting of mental health outcomes in Canada might be advanced including efforts at engaging both clinicians and decision-makers.

show abstract

Section: Demographic and Diagnostic Characteristics Of The Populationsupporting

confidence: 71%

Routine outcome measures in Canada

Kisely

Adair

Lin

et al. 2015

International Review of Psychiatry

View full text Add to dashboard Cite

show abstract

“…These concerns are compounded by the lack of robust evidence from other studies for associations of HoNOS scores with costs,[17–19,21–23] operationalisation and validity issues [28,29], and the fact that the HoNOS were designed to measure clinical outcome rather than need for care. [49]…”

Section: Discussionmentioning

confidence: 99%

Utility of the Health of the Nation Outcome Scales (HoNOS) in Predicting Mental Health Service Costs for Patients with Common Mental Health Problems: Historical Cohort Study

et al. 2016

View full text Add to dashboard Cite

BackgroundFew countries have made much progress in implementing transparent and efficient systems for the allocation of mental health care resources. In England there are ongoing efforts by the National Health Service (NHS) to develop mental health ‘payment by results’ (PbR). The system depends on the ability of patient ‘clusters’ derived from the Health of the Nation Outcome Scales (HoNOS) to predict costs. We therefore investigated the associations of individual HoNOS items and the Total HoNOS score at baseline with mental health service costs at one year follow-up.MethodsAn historical cohort study using secondary care patient records from the UK financial year 2012–2013. Included were 1,343 patients with ‘common mental health problems’, represented by ICD-10 disorders between F32-48. Costs were based on patient contacts with community-based and hospital-based mental health services. The costs outcome was transformed into ‘high costs’ vs ‘regular costs’ in main analyses.ResultsAfter adjustment for covariates, 11 HoNOS items were not associated with costs. The exception was ‘self-injury’ with an odds ratio of 1.41 (95% CI 1.10–2.99). Population attributable fractions (PAFs) for the contribution of HoNOS items to high costs ranged from 0.6% (physical illness) to 22.4% (self-injury). After adjustment, the Total HoNOS score was not associated with costs (OR 1.03, 95% CI 0.99–1.07). However, the PAF (33.3%) demonstrated that it might account for a modest proportion of the incidence of high costs.ConclusionsOur findings provide limited support for the utility of the self-injury item and Total HoNOS score in predicting costs. However, the absence of associations for the remaining HoNOS items indicates that current PbR clusters have minimal ability to predict costs, so potentially contributing to a misallocation of NHS resources across England. The findings may inform the development of mental health payment systems internationally, especially since the vast majority of countries have not progressed past the early stages of this development. Discrepancies between our findings with those from Australia and New Zealand point to the need for further international investigations.

show abstract

“…The Norwegian version of HoNOSCA has been found to have good psychometric properties, with good inter-rater reliability, good sensitivity to change, and good concurrent and criterion-related validity [ 49 ]. The HONOSCA have also been found to be sensitive to change in clinical populations [ 4 , 5 , 18 , 19 , 24 , 32 , 33 , 47 ]. In the present study, total score changes were evaluated.…”

Section: Methodsmentioning

confidence: 99%

Predictors of rate of change for children and youth with emotional disorders: a naturalistic observational study

Nilsen

Handegård

Eisemann

et al. 2016

Child Adolesc Psychiatry Ment Health

View full text Add to dashboard Cite

BackgroundTo examine demographic and clinical characteristics as potential predictors of change for children and youth with emotional disorders treated at two child and adolescent mental health outpatient services (CAMHS) in Norway.MethodsThe study was of naturalistic observational type with “treatment as usual” (TAU). The sample consisted of 84 children and youth with emotional disorders. The Health of the Nation Outcome Scale (HONOSCA), and the Children’s Global Assessment Scale (CGAS) were administered at intake (T0), during the assessment (T1) and approximately six months after assessment (T2). Change was analysed by means of the linear mixed models procedure.ResultsFor the HONOSCA total score, youths with a diagnosis of depression had statistically higher symptom severity levels at baseline and significantly lower change rates as compared to youths with an anxiety disorder.ConclusionsThe current study adds to the limited knowledge of predictors of rate of change for children and adolescents with emotional disorders treated within CAMHS. Our results point to a special need to improve clinical care for depressed children and adolescents. Important limitations comprising the external validity of the study concern missing data, a small study sample, and lack of information regarding the content and extent of the service provided.Electronic supplementary materialThe online version of this article (doi:10.1186/s13034-016-0098-3) contains supplementary material, which is available to authorized users.

show abstract

Do the Health of the Nation Outcome Scales Measure Outcome?

Cited by 34 publications

References 20 publications

Routine outcome measures in Canada

Routine outcome measures in Canada

Utility of the Health of the Nation Outcome Scales (HoNOS) in Predicting Mental Health Service Costs for Patients with Common Mental Health Problems: Historical Cohort Study

Predictors of rate of change for children and youth with emotional disorders: a naturalistic observational study

Contact Info

Product

Resources

About