Application of Level of Care Utilization System for Psychiatric and Addiction Services (LOCUS) to Psychiatric Practice in Japan: A Preliminary Assessment of Validity and Sensitivity to Change

We applied an American medical necessity scale, Level of Care Utilization System for Psychiatric and Addiction Services (LOCUS), to psychiatric practice in Japan. This is an exploratory analysis of empirical data of 272 patients. We examined the relationships between levels of care of LOCUS and clin...

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Bibliographic Details
Published inCommunity mental health journal Vol. 49; no. 4; pp. 477 - 491
Main Authors Kimura, Taku, Yagi, Fukashi, Yoshizumi, Akira
Format Journal Article
LanguageEnglish
Published Boston Springer US 01.08.2013
Springer Nature B.V
Subjects
Addictions
Admissions
Adult
Assessment
Community and Environmental Psychology
Community Mental Health Services
Decision making
Female
Health services utilization
Hospitals
Humans
Japan
Male
Medical necessity
Medicine
Medicine & Public Health
Mental health
Middle Aged
Needs Assessment - standards
Original Paper
Patient Admission
Psychiatric services
Psychiatrists
Psychiatry
Sensitivity analysis
Service provision
Validity
Japan
Sensitivity to change
Validity
LOCUS
Level of care
Community-based psychiatric care
Admission criteria
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Summary:We applied an American medical necessity scale, Level of Care Utilization System for Psychiatric and Addiction Services (LOCUS), to psychiatric practice in Japan. This is an exploratory analysis of empirical data of 272 patients. We examined the relationships between levels of care of LOCUS and clinical variables, contribution of care levels on admission decision, and changes in care levels over time. Inpatients showed significantly higher levels of care than outpatients. Levels of care showed significant strong inverse correlations to Global Assessment Scale (GAS) scores, and significant moderate correlations to admission types, care environment, and diagnostic subgroups in almost all groups. Levels of care contributed as much to the admission decision as GAS scores. Levels of care significantly decreased from the time of admission to discharge. Our preliminary evidence indicates that LOCUS is valid and sensitive to change, and applicable for clinical use in Japan.
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ISSN:0010-3853
1573-2789
DOI:10.1007/s10597-012-9562-6