Impact of compulsory community treatment on admission rates: Survival analysis using linked mental health and offender databases
Author(s)
Kisely, SR
Xiao, JG
Preston, NJ
Griffith University Author(s)
Year published
2004
Metadata
Show full item recordAbstract
Background There is controversy as to whether compulsory community treatment for psychiatric patients reduces hospital admission rates. Aims To examine whether community treatment orders (CTOs) reduce admission rates, using a two-stage design of matching and multivariate analyses to take into account socio-demographic factors, clinical factors, case complexity and previous psychiatric and forensic history. Method Survival analysis of CTO cases and controls from three linked Western Australian databases of health service use, involuntary treatment and forensic history. We used two control groups: one matched on demographic ...
View more >Background There is controversy as to whether compulsory community treatment for psychiatric patients reduces hospital admission rates. Aims To examine whether community treatment orders (CTOs) reduce admission rates, using a two-stage design of matching and multivariate analyses to take into account socio-demographic factors, clinical factors, case complexity and previous psychiatric and forensic history. Method Survival analysis of CTO cases and controls from three linked Western Australian databases of health service use, involuntary treatment and forensic history. We used two control groups: one matched on demographic characteristics, diagnosis, past psychiatric history and treatment setting, and consecutive controls matched on date of discharge from in-patientcare. Results We matched 265 CTO cases with 265 matched controls and 224 consecutive controls (total n=754). The CTO group had a significantly higher readmission rate: 72% v. 65% and 59% for the matched and consecutive controls (log-rank {chi}2=4.7, P=0.03). CTO placement, aboriginal ethnicity, younger age, personality disorder and previous health service use were associated with increased admission rates. Conclusions Community treatment orders alone do not reduce admissions.
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View more >Background There is controversy as to whether compulsory community treatment for psychiatric patients reduces hospital admission rates. Aims To examine whether community treatment orders (CTOs) reduce admission rates, using a two-stage design of matching and multivariate analyses to take into account socio-demographic factors, clinical factors, case complexity and previous psychiatric and forensic history. Method Survival analysis of CTO cases and controls from three linked Western Australian databases of health service use, involuntary treatment and forensic history. We used two control groups: one matched on demographic characteristics, diagnosis, past psychiatric history and treatment setting, and consecutive controls matched on date of discharge from in-patientcare. Results We matched 265 CTO cases with 265 matched controls and 224 consecutive controls (total n=754). The CTO group had a significantly higher readmission rate: 72% v. 65% and 59% for the matched and consecutive controls (log-rank {chi}2=4.7, P=0.03). CTO placement, aboriginal ethnicity, younger age, personality disorder and previous health service use were associated with increased admission rates. Conclusions Community treatment orders alone do not reduce admissions.
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Journal Title
British Journal of Psychiatry
Volume
184
Issue
5
Publisher URI
Subject
Biomedical and clinical sciences
Clinical sciences not elsewhere classified
Psychology