Shalvata Mental Health Center, Hod Hasharon, affiliated with the Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel.
Department of Behavioral Sciences, Ariel University, 40700, Ariel, Israel.
Psychiatr Q. 2020 Dec;91(4):1453-1463. doi: 10.1007/s11126-020-09772-z.
Deliberative efforts are constantly made to provide community-based mental health rehabilitation services to people with mental health disabilities nationwide. In this study we aimed to assess the effectiveness of rehabilitation services in Israel by assessing the impact of utilization of rehabilitation services on hospitalization rates among a cohort of patients diagnosed with schizophrenia. Data derived from the Clalit Health Services were crossed with the Ministry of Health rehabilitation and psychiatric hospitalization case registries. Patients utilizing rehabilitation services were assessed for rates and durations of hospitalizations before and after the utilization of the rehabilitation services, and were compared to patients who did not use these services (n = 185). Mixed-model analyses of covariance (ANCOVA) were conducted to assess changes in rates and durations of hospitalizations at the beginning and end of the cohort period. Patients who used rehabilitation services showed higher rates and durations of hospitalizations prior to utilization of rehabilitation services, as well as higher decreases in number and duration of hospitalizations after utilizing their rights to rehabilitation services, as compared to patients who did not receive these services. Schizophrenia patients tend to show a decreasing trend in number and duration of hospitalizations over time. Nonetheless, the utilization of rehabilitation services offers larger gains in hospitalization prevention, primarily to schizophrenia patients who experience high rates and durations of hospitalizations at the beginning of illness. These findings provide additional support for the necessity of rehabilitation services, primarily for patients with severe onset.
全国范围内，人们一直在努力提供基于社区的精神卫生康复服务。本研究旨在通过评估康复服务的利用对精神分裂症患者队列住院率的影响，来评估以色列康复服务的效果。从克拉利特医疗保健服务机构获得的数据与卫生部康复和精神科住院病例登记处进行了交叉。利用康复服务的患者在利用康复服务前后的住院率和住院时间进行了评估，并与未使用这些服务的患者（n=185）进行了比较。采用协方差混合模型分析（ANCOVA）来评估队列开始和结束时住院率和住院时间的变化。与未接受这些服务的患者相比，利用康复服务的患者在利用康复服务之前的住院率和住院时间更高，在利用康复服务权利后，住院人数和住院时间的减少幅度也更大。精神分裂症患者的住院人数和时间随着时间的推移呈下降趋势。尽管如此，康复服务的利用在预防住院方面带来了更大的收益，主要是针对在疾病开始时住院率和住院时间较高的精神分裂症患者。这些发现为康复服务的必要性提供了额外的支持，主要是针对发病严重的患者。
