The effect of inpatient care on measured Health Needs in children and adolescents.

BACKGROUND The concept of 'health need' relates patient problems in symptom and psychosocial domains to available appropriate treatments. We studied the effectiveness of inpatient treatment in modifying measured 'Health Needs' in children and adolescents admitted to UK inpatient units. METHODS A prospective cohort study of 150 children and adolescents admitted to eight UK inpatient units, using formal pre-admission, pre-discharge and 1-year follow-up measurement of Health Needs. RESULTS Total patient 'Cardinal Problems' reduced highly significantly (p < .001) from 8.5 at admission to 5.7 at discharge (effect size .81) and to 4.1 one year after discharge (effect size 1.35). Functional domains free of 'Health Needs' increased from 14.9 to 19.4 (effect size 1.08) from the point of admission to the end of follow-up. These changes were clinically meaningful, present in all domains and reduced morbidity to a level typical of outpatient cases. CONCLUSIONS Admission (mean length 116 days, SD 88) leads to clinically important improvement in measured Health Needs over multiple domains for children with serious, complex mental health difficulties. These improvements in multiple symptom and functional domains persist over the next year.