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Brief Reports   |    
Effectiveness of Assertive Community Treatment in Hong Kong Among Patients With Frequent Hospital Admissions
Shu Keung Liem, M.R.C.Psych., F.H.K.C.Psych.; Chi Chiu Lee, M.R.C.P., F.H.K.C.Psych.
Psychiatric Services 2013; doi: 10.1176/appi.ps.201200421
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The authors are with Clinical Management Team 5, Kwai Chung Hospital, 3-15 Kwai Chung Hospital Rd., the New Territories, Hong Kong, China (e-mail: liemsk@ha.org.hk).

Copyright © 2013 by the American Psychiatric Association


Objective  This study examined the effectiveness of assertive community treatment (ACT) for a group of psychiatric patients in Hong Kong with frequent hospital admissions.

Methods  The study compared hospitalization and other outcomes among participants of a two-year ACT intervention and a control group who had received treatment as usual two years earlier. The patients were Chinese adult psychiatric patients who had three or more admissions in the 12 months before the study.

Results  Seventy patients were recruited for each group. Although all the outcome measures decreased with time for both groups, repeated-measures analysis of variance indicated that the treatment group had significantly greater reductions in readmission rate, length of stay, and total days between a missed medical appointment and the next service contact.

Conclusions  ACT was effective in reducing hospitalization and enhancing service contacts for a group of Chinese psychiatric patients with frequent hospital admissions.

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Table 1Repeated-measures ANOVA comparing outcomes between patients who received ACT (treatment group) or usual care (control group)a
Table Footer Note

a ANOVA, analysis of variance; ACT, assertive community treatment

Table Footer Note

b Outcomes were assessed at 12-month and 24-month follow-ups.

Table Footer Note

e Cumulative days between missed medical appointments and date of next service contact



Marshall  M;  Lockwood  A:  Assertive community treatment for people with severe mental disorders (withdrawn).  Cochrane Database of Systematic Reviews 4:CD001089, 2011
Marshall  M;  Gray  A;  Lockwood  A  et al:  Case management for people with severe mental disorders (withdrawn).  Cochrane Database of Systematic Reviews 4:CD000050, 2011
Marshall  M:  Case management: a dubious practice.  British Medical Journal 312:523–524, 1996
[CrossRef] | [PubMed]
Marshall  M;  Lockwood  A;  Gath  D:  Social services case-management for long-term mental disorders: a randomised controlled trial.  Lancet 345:409–412, 1995
[CrossRef] | [PubMed]
Rosen  A:  Community psychiatry services: will they endure? Current Opinion in Psychiatry 5:257–265, 1992
McGrew  JH;  Bond  GR;  Dietzen  L  et al:  Measuring the fidelity of implementation of a mental health program model.  Journal of Consulting and Clinical Psychology 62:670–678, 1994
[CrossRef] | [PubMed]
Burns  T;  Catty  J;  Dash  M  et al:  Use of intensive case management to reduce time in hospital in people with severe mental illness: systematic review and meta-regression.  British Medical Journal 335:336, 2007
[CrossRef] | [PubMed]
Wright  C;  Catty  J;  Watt  H  et al:  A systematic review of home treatment services—classification and sustainability.  Social Psychiatry and Psychiatric Epidemiology 39:789–796, 2004
Roick  C;  Heider  D;  Kilian  R  et al:  Factors contributing to frequent use of psychiatric inpatient services by schizophrenia patients.  Social Psychiatry and Psychiatric Epidemiology 39:744–751, 2004
[CrossRef] | [PubMed]
Lee  CC;  Chiu  SN;  Wong  CW  et al:  The second deinstitutionalization project for severely mentally ill patients in Kwai Chung Hospital: a randomised controlled trial.  Hong Kong Medical Journal 14:36–40, 2008
Rothbard  AB;  Kuno  E;  Schinnar  AP  et al:  Service utilization and cost of community care for discharged state hospital patients: a 3-year follow-up study.  American Journal of Psychiatry 156:920–927, 1999
Bond  GR;  McGrew  JH;  Fekete  DM:  Assertive outreach for frequent users of psychiatric hospitals: a meta-analysis.  Journal of Mental Health Administration 22:4–16, 1995
[CrossRef] | [PubMed]
Kent  S;  Yellowless  P:  Psychiatric and social reasons for frequent rehospitalization.  Psychiatric Services 45:347–350, 1994
Bond  GR;  Witheridge  TF;  Dincin  J  et al:  Assertive community treatment for frequent users of psychiatric hospitals in a large city: a controlled study.  American Journal of Community Psychology 18:865–891, 1990
[CrossRef] | [PubMed]
Holloway  F;  Carson  J:  Intensive case management for the severely mentally ill: controlled trial.  British Journal of Psychiatry 172:19–22, 1998
[CrossRef] | [PubMed]
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