DAY HOSPITAL CRISIS RESPITE CARE VERSUS INPATIENT CARE .1. CLINICAL OUTCOMES

Objective: The authors investigated the clinical feasibility and the o utcomes for patients of a program designed as an alternative to acute hospitalization. Method: This was a random-design study comparing a co nventional inpatient program for urban, poor, severely ill voluntary p atients who usually require hospitalization to an alternative experime ntal program consisting of a day hospital linked to a crisis residence . Patients were assessed with standardized measures of symptoms, funct ioning, social adjustment, quality of life, and satisfaction with clin ical services upon admission to the study, at discharge from the index admission, and at follow-ups 2, 5, and 10 months after discharge. Res ults: One hundred ninety-seven patients were enrolled in the 2-year re search program and followed for 10 months. Of the voluntary patients w ho would have been admitted to the hospital, 83% were appropriate for the experimental program. The clinical, functional, social adjustment, quality of life, and satisfaction outcome measures were not statistic ally different for the patients in the two treatment conditions; howev er, there was a slightly more positive effect of the experimental prog ram on measures of symptoms, overall functioning, and social functioni ng. Conclusions: The experimental condition, a combined day hospital/c risis respite community residence, seems to have had the same treatmen t effectiveness as acute hospital care for urban, poor, acutely ill vo luntary patients with severe mental illness.