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Impact of community treatment orders on inpatient bed usage in assertive outreach team

BJPsych open, 2021-06, Vol.7 (S1), p.S233-S234 [Peer Reviewed Journal]

Copyright © The Author(s), 2021. Published by Cambridge University Press on behalf of the Royal College of Psychiatrists ;Copyright © The Author(s), 2021. Published by Cambridge University Press on behalf of the Royal College of Psychiatrists. This work is licensed under the Creative Commons Attribution License http://creativecommons.org/licenses/by/4.0/ (the “License”). Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License. ;The Author(s) 2021 2021 The Author(s) ;ISSN: 2056-4724 ;EISSN: 2056-4724 ;DOI: 10.1192/bjo.2021.625

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  • Title:
    Impact of community treatment orders on inpatient bed usage in assertive outreach team
  • Author: Al-Uzri, Mohammed ; Harvey, Zena ; Noushad, Fabida ; Iheonu, Chinyere ; Abbas, Mohammed
  • Subjects: Cost control ; ePoster Presentations
  • Is Part Of: BJPsych open, 2021-06, Vol.7 (S1), p.S233-S234
  • Description: Aims To examine the impact of using Communty Treatment Orders (CTO) of the Mental Health Act on use of inpatient care in Assertive Outreach team. Background Currently there is little evidence of the efficacy of community treatment orders (CTOs), and in particular with patients who use the Assertive Outreach service. One large randomised controlled study found no impact on use of inpatient care while a naturalistc study found significant impact. Method Our primary outcome was the number of admissions with and without a CTO comparing each patient with themselves before CTO and under CTO(“mirror-image”). Our secondary outcomes were the number of bed days, and the percentage of missed community visits post-discharge. We also looked at the potential cost savings of a reduction in inpatient bed usage. Result All the 63 patients studied over period of 6 years had a severe and enduring mental illness. The use of a CTO was linked to a significant reduction in the number of admissions (mean difference = 0.89, 95% CI = 0.53–1.25, P < 0.0001) and bed days (mean difference = 158.65, 95% CI = 102.21–215.09, P < 0.0001) There was no significant difference in the percentage of missed community visits post-discharge. Looking at the costs, an average cost for an inpatient Assertive Outreach bed per day in the local Trust was £250, and there were 8145 bed days saved in total, making a potential saving of just over £2million, during the study period. Conclusion This study suggests that the implementation of CTOs using clinical judgment and knowledge of patients can significantly reduce the bed usage of Assertive Outreach patients. The financial implications of CTOs need to be reviewed further, but this study does suggest that the implementation of CTOs is a cost-effective intervention and is economically advantageous to the local Trust.
  • Publisher: Cambridge, UK: Cambridge University Press
  • Language: English
  • Identifier: ISSN: 2056-4724
    EISSN: 2056-4724
    DOI: 10.1192/bjo.2021.625
  • Source: ProQuest One Psychology
    Open Access: DOAJ Directory of Open Access Journals
    Directory of Open Access Scholarly Resources (ROAD)
    PubMed Central (Open access)
    AUTh Library subscriptions: ProQuest Central
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