OBJECTIVE: The utility of the Treatment Outcome Profile (TOP) for
measuring the effectiveness of acute inpatient psychiatric and substance
abuse treatment was tested, including its internal reliability, validity,
and sensitivity to treatment gains. The relationship between patients'
satisfaction with services and treatment gains in quality of life,
symptoms, and level of functioning was explored. METHODS: A pre-post
research design was used with consecutive admissions to an inpatient
psychiatric unit (N = 66) and a substance abuse treatment unit (N = 88) at
a VA medical center. At admission and at discharge, the TOP, a self-report
instrument assessing quality of life, symptoms, level of functioning, and
patient satisfaction with services (at discharge only) was completed.
Multivariate analysis of variance and univariate analysis of variance were
used to test differences in scores between admission and discharge.
RESULTS: Patients demonstrated significant treatment gains. Overall,
compared with patients on the substance abuse unit, those receiving
psychiatric treatment were more impaired at admission and had lower levels
of self- reported therapeutic gain at discharge. Improvement for both
groups occurred in quality of life, symptoms, and level of functioning.
Both groups reported high levels of patient satisfaction, comparable with
levels in other service industries. A high positive correlation (alpha =
.61) was found between patient satisfaction and overall self-reported
treatment gain. CONCLUSIONS: The results indicate that it is important to
compare treatment effectiveness as well as costs when seeking less costly
alternatives to inpatient care. The TOP is a valid and sensitive outcome
measurement tool. Patient satisfaction is an important outcome variable and
positively related to treatment gains in quality of life, symptoms, and
level of functioning.