Conditional release in Western Australia: Effect on hospital length of stay

Segal, S. P., Preston, N., Kisely, S. and Xiao, J. G. (2009) Conditional release in Western Australia: Effect on hospital length of stay. Psychiatric Services, 60 1: 94-99. doi:10.1176/appi.ps.60.1.94


Author Segal, S. P.
Preston, N.
Kisely, S.
Xiao, J. G.
Title Conditional release in Western Australia: Effect on hospital length of stay
Journal name Psychiatric Services   Check publisher's open access policy
ISSN 1075-2730
Publication date 2009-01
Year available 2009
Sub-type Article (original research)
DOI 10.1176/appi.ps.60.1.94
Volume 60
Issue 1
Start page 94
End page 99
Total pages 6
Place of publication Washington, D.C., U.S.
Publisher American Psychiatric Association
Collection year 2010
Language eng
Subject 11 Medical and Health Sciences
1103 Clinical Sciences
110319 Psychiatry (incl. Psychotherapy)
C1
Formatted abstract
Objective: The goal of this study was to determine whether the introduction of community treatment orders, which allow for conditional release from a psychiatric hospital, reduced inpatient episode durations in Western Australia by providing an alternative to extended inpatient stays.
Methods: The design compared 129 persons given community treatment orders and 117 matched control patients without such orders—all of whom were hospitalized during the same period both before and after the introduction of the community treatment order law that allows for conditional release. A multivariate analysis of covariance was used to evaluate the impact of community treatment orders on change in inpatient episode duration.
Results: The model showed a significant effect on inpatient episode duration (R2=.23, adjusted R2=.17, N=243, F=3.99, df=17 and 226, p<.001), indicating that community treatment orders (after taking all control factors into account) enabled a 19.16-day reduction per episode of inpatient care (t=2.13, df=1, p=.034) for persons given conditional release. Community-initiated treatment orders intended to prevent hospitalization, yet failing to do so, were associated with increased duration of subsequent hospitalizations (35.18 days; t=–3.36, df=1, p<.001).
Conclusions: Community treatment orders can be a useful tool for some but not necessarily all objectives. In the form of conditional release, orders reduce the likelihood of extended hospital stays. As a means to prevent hospitalization, the utility of community treatment orders is more complex, being dependent on services provided and on the judicious selection of persons for these orders.
Keyword Compulsory community treatment
Involuntary outpatient commitment
Linked mental health
Psychiatric treatment
Offender databases
Treatment orders
Impact
Illness
Services
Q-Index Code C1
Q-Index Status Provisional Code

Document type: Journal Article
Sub-type: Article (original research)
Collection: School of Health and Rehabilitation Sciences Publications
 
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Citation counts: TR Web of Science Citation Count  Cited 11 times in Thomson Reuters Web of Science Article | Citations
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Created: Wed, 18 Nov 2009, 12:22:34 EST