The Health of the Nation Outcome Scales in psychiatric hospitalisation: a multicentre study examining outcome and prediction of length of stay

Objective: The Health of the Nation Outcome Scales (HoNOS) is a reliable instrument, useful in detecting change in symptoms and functioning during psychiatric hospitalisation. The present study examines its utility in predicting length of stay of patients in six private psychiatric hospitals in four Australian States. Method: The HoNOS was administered on admission and discharge in six private psychiatric hospitals in Australia. Results: There were significant differences in total score and in all sub-scales between admission and discharge. There were no significant associations between total HoNOS scores and length of stay, either for individual hospitals or for specific diagnosis-related groups. There were only very weak associations, of doubtful practical clinical significance, between length of stay of all patients and individual HoNOS sub-scales. Conclusion: While the HoNOS is of some value in providing a readily administered and understood measure for clinicians, on the basis of these findings it is unlikely to be of utility in predicting length of stay or in offering a 'gate-keeping' service in decision-making in regard to the allocation of resources for individual patients.