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A Pilot Investigation of the Relationship Between Community Treatment Orders and Hospital Utilization Rates

Objectives: The aim of this project was to assess the effect of community treatment orders (CTOs) on local hospital utilization rates. Methods: We undertook a pre-post comparison of the number of admissions and the total length of hospital stay for all 28 patients of the Hunter Valley Mental Health Service who were on a CTO at the audit date (31 July 2008). At that time, there were 611 active patients being managed by the service. Results: Twice the number of admissions per annum (2.54 versus 1.14 admissions, p < 0.001) and length of stay (41.58 versus 20.23 days, p < 0.01) were observed during the pre-CTO year compared to the CTO period. However, there were no significant differences when the index admission was excluded from these analyses (1.54 versus 1.14 admissions, 20.00 versus 20.23 days in hospital). Conclusion: CTOs have doubtful value in reducing hospital utilization, which may not be an appropriate outcome measure to study CTO effectiveness.