Levinson Daphna, Lerner Yaacov, Lichtenberg Pesach
Mental Health Services, Ministry of Health, Jerusalem, Israel.
Isr J Psychiatry Relat Sci. 2003;40(4):240-7.
The purpose of the present study was to investigate trends over the past 40 years in the accumulated length of hospital stay, and to consider how these trends might have been affected by changes in the provision of mental health care in Israel from 1960 to 1997.
The national psychiatric case register was used to follow four cohorts of all new admissions in 1960, 1970, 1980 and 1990 diagnosed with schizophrenia or affective disorders for the first seven years following the index admission.
Most of the changes in length of stay occurred among patients with schizophrenia. The overall accumulated length of stay decreased by 50% between 1960 and 1980. The largest reduction was observed among long-stay patients with schizophrenia. Number of admissions did not change for the four cohorts.
The interpretation of the data remains speculative, as we are attempting to establish causality between parallel trends.
The general trend in the findings of this study corresponds with changes that took place between 1970 and 1990 in the outpatient care for the mentally ill. These innovations facilitated the discharge of patients with chronic schizophrenia and altered the case mix of the newly admitted patients.
本研究的目的是调查过去40年住院总时长的变化趋势，并探讨1960年至1997年以色列精神卫生保健服务的变化如何影响这些趋势。
利用国家精神病病例登记册，对1960年、1970年、1980年和1990年首次入院诊断为精神分裂症或情感障碍的四组队列患者进行索引入院后的头七年随访。
住院时长的大部分变化发生在精神分裂症患者中。1960年至1980年期间，总住院时长下降了50%。在长期住院的精神分裂症患者中观察到最大降幅。四组队列的入院人数没有变化。
由于我们试图在平行趋势之间建立因果关系，数据的解释仍具有推测性。
本研究结果的总体趋势与1970年至1990年期间精神病患者门诊护理的变化相一致。这些创新措施促进了慢性精神分裂症患者的出院，并改变了新入院患者的病例组合。
