Patients' perceptions of their quality of life 11 years after discharge from a state hospital

What Works? Toward a New Classification System for Mental Health Supported Accommodation Services: The Simple Taxonomy for Supported Accommodation (STAX-SA)

Inconsistent terminology and variation in service models have made synthesis of the supported accommodation literature challenging. To overcome this, we developed a brief, categorical taxonomy that aimed to capture the defining features of different supported accommodation models: the simple taxonomy for supported accommodation (STAX-SA). Data from a previous review of existing classification systems were used to develop the taxonomy structure. After initial testing and amendments, the STAX-SA and an existing taxonomy were applied to 132 supported accommodation service descriptions drawn from two systematic reviews and their performance compared. To assess external validity, the STAX-SA was distributed to a sample of supported accommodation managers in England and they were asked to use it to classify their services. The final version of the STAX-SA comprised of five supported accommodation 'types', based on four domains; Staffing location; Level of support; Emphasis on move-on; and Physical setting. The STAX-SA accurately categorized 71.1% (n = 94) of service descriptions, outperforming the comparison tool, and was not affected by publication date or research design. The STAX-SA effectively discriminated between 'real world' service models in England and 53.2% (n = 17) of service managers indicated that the taxonomy was 'Very effective' or 'Extremely effective' in capturing key characteristics of their service. The STAX-SA is an effective tool for classifying supported accommodation models and represents a promising approach to synthesizing the extant effectiveness literature. The authors recommend the development of reporting guidelines for future supported accommodation publications to facilitate comparison between models.

Discharge disposition after bariatric surgery

Weight loss continues for extended time post-bariatric surgery; thus, discharge destination is an important factor to consider when examining outcomes of surgery. The Agency for Healthcare Research and Quality State Inpatient Database was utilized to identify patients with bariatric surgery and to determine factors associated with and predictive of home discharge. Patients that were discharged home had shorter length of stays, lower total hospital costs, fewer chronic conditions, and lower readmission rates. Factors predictive of discharge were identified. Being discharged home could be associated with characteristics vital to patient's long-term weight loss. It is imperative to focus on factors predictive of home discharge in order to reap the most beneficial outcomes of surgery.

Quality of life as an outcome measure in evaluating mental health services: a review of the empirical evidence

This paper addresses the question of how well quality of life measures function as valid and sensitive outcome indicators of mental health services. Findings from the major empirical studies of quality of life in the mental health area over the last 15 years are reviewed. The extent to which existing studies provide evidence of the ability of quality of life measures to discriminate the impact of service interventions on the well-being of psychiatric clients is examined. Findings from cross-sectional, comparative, repeated-measures and randomised studies are presented. The available empirical evidence is critically examined and the methodological and theoretical implications of current findings for future work are considered.