Page 54 - Demo

Chapter 25226.44, p < .001). Additionally, the slope for the period after week 1 of 2021 was significantly lower than the slope before the first week of 2021 (b = -0.0069, SE = 0.00025, t = -27.49, p < .001), showing accelerated decrease in weekly counts of involuntary care recordings over the course of 2021 (standardised mean difference: -0.271 standard deviations, 95% CI [-0.29, -0.251]). Sensitivity analysisThe Theil-Sen test was used to test for the change in slope throughout the study period. No seasonality was observed in the data. Results from the TheilSen tests were consistent with the Poisson regression models, showing a statistically significant decrease in slope from the period before the introduction of the CCA to the period after the Act came into force (Theil-Sen estimator = -108.75, SE = 78.86, p < .001), and from the period before and after the Act was fully implemented (Theil-Sen estimator = -148.23, SE = 83.12, p < .001).DiscussionThe CCA coming into force on 1 January 2020 had an impact on the extent to which involuntary care was recorded for people with intellectual disability in long-term care. Already during the period in which the new Act was announced, counts were dropping, as restrictive measures recorded under the old Special Admissions Act expired while new practices around involuntary care and recording were not yet established. Given the attention around the new Act and the implementation of new instructions for registering involuntary care, a temporary increase in recordings was expected in the first period of the new law. On the contrary, counts of recordings of involuntary care decreased throughout the first half of 2020. Marking 2020 as a transitional year for implementing the CCA within the care organisation, the second half of 2020 saw a temporary rise in recorded forms of involuntary care, after which the decrease resumed its course in 2021.The decrease in recordings after the new Act coming into force and being fully implemented (start of 2020 and 2021, respectively) might be explained by differences between the Special Admissions Act and the CCA. In contrast to the old Act which obligated care professionals to record all restrictive measures, the new Act demands registrations only when clients resist or