Is Engagement Associated with Outcome in Assertive Outreach?

Background: Many studies have examined the impact of Assertive Outreach management on hospital usage. However, there has been little attempt to examine the possible role of engagement in reducing hospital usage despite the emphasis on the importance of engagement in delivering care in such services.

Aim: The main aim of the study was to investigate the relationship between engagement and hospital usage.

Method: An observer rated measure of engagement was completed on 45 clients who had been under the management of an Assertive Outreach team (AOT) for a minimum of 1 year. This was compared (together with clinical and demographic factors) to hospital usage; notably bed days and admission rates before AOT and under AOT.

Results: Certain indices of engagement were associated with fewer admissions and less bed days under AOT: perceived usefulness of treatment, quality of client-therapist interaction and openness. Engagement factors which were least predictive of outcome were those concerning compliance with medication and appointment keeping. Clients' overall level of engagement was not associated with reduced hospital usage. Assertive Outreach management was associated with a reduction in the number of admissions per year but not with fewer bed days per year.

Conclusions: Client Engagement is useful in AOT populations and may be a useful outcome indicator for the Future.

Declaration of interest: None—no external funding or support involved.