The utility of outpatient commitment: acute medical care access and protecting health View Full Text


Ontology type: schema:ScholarlyArticle      Open Access: True


Article Info

DATE

2018-04-06

AUTHORS

Steven P. Segal, Stephania L. Hayes, Lachlan Rimes

ABSTRACT

ObjectivesThis study considers whether, in an easy access single-payer health care system, patients placed on outpatient commitment—community treatment orders (CTOs) in Victoria Australia—are more likely to access acute medical care addressing physical illness than voluntary patients with and without severe mental illness.MethodFor years 2000 to 2010, the study compared acute medical care access of 27,585 severely mentally ill psychiatrically hospitalized patients (11,424 with and 16,161 without CTO exposure) and 12,229 never psychiatrically hospitalized outpatients (individuals with less morbidity risk as they were not considered to have severe mental illness). Logistic regression was used to determine the influence of the CTO on the likelihood of receiving a diagnosis of physical illness requiring acute care.ResultsValidating their shared and elevated morbidity risk, 53% of each hospitalized cohort accessed acute care compared to 32% of outpatients during the decade. While not under mental health system supervision, however, the likelihood that a CTO patient would receive a physical illness diagnosis was 31% lower than for non-CTO patients, and no different from lower morbidity-risk outpatients without severe mental illness. While, under mental health system supervision, the likelihood that CTO patients would receive a physical illness diagnosis was 40% greater than non-CTO patients and 5.02 times more likely than outpatients were. Each CTO episode was associated with a 4.6% increase in the likelihood of a member of the CTO group receiving a diagnosis.ConclusionMental health system involvement and CTO supervision appeared to facilitate access to physical health care in acute care settings for patients with severe mental illness, a group that has, in the past, been subject to excess morbidity and mortality. More... »

PAGES

597-606

References to SciGraph publications

  • 2014-02-22. The prevalence of metabolic syndrome in people with severe mental illness: a mediation analysis in SOCIAL PSYCHIATRY AND PSYCHIATRIC EPIDEMIOLOGY
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    URI

    http://scigraph.springernature.com/pub.10.1007/s00127-018-1510-5

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    http://dx.doi.org/10.1007/s00127-018-1510-5

    DIMENSIONS

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    PUBMED

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