Florentin Sharon, Neumark Yehuda, Roe David, Rosca Paola, Keller Shikma, Amir Noa Yakirevich, Krivoy Amir
Department of Psychiatry, Hadassah Medical Center, Jerusalem, Israel; Faculty of Medicine, The Hebrew University of Jerusalem, Jerusalem, Israel.
Braun School of Public Health & Community Medicine, Faculty of Medicine, The Hebrew University of Jerusalem, Israel.
Psychiatry Res. 2024 Dec;342:116216. doi: 10.1016/j.psychres.2024.116216. Epub 2024 Sep 23.
Psychiatric rehabilitation is essential for the recovery of individuals with schizophrenia. However, re-hospitalization is sometimes inevitable. This study examined the association between varied community psychiatric rehabilitation services (PRS) and long-term re-hospitalization parameters. National registries provided data on 5163 adults diagnosed with schizophrenia and schizoaffective disorder. Patients with recurrent hospitalizations were tracked over three periods: before rehabilitation legislation (1991-2000), during rehabilitation implementation (2001-2009), and follow-up (2010-2017). Associations between PRS types and annual re-hospitalization days (ARHD) during follow-up were analyzed. Findings revealed that the rehabilitation group had a median time-to-readmission of 757 days, while the non-rehabilitation group had 321 days. Combined residential and vocational rehabilitation was associated with a 20-day decrease in ARHD, while residential or vocational rehabilitation alone were associated with reductions of 2 and 5 days, respectively. Higher levels of residential support were linked to reduced ARHD. Of the vocational rehabilitation types, supported-employment and sheltered-workshops showed association with the greatest reductions in ARHD (17 days). Overall, community-based PRS is linked to prolonged time-to-readmission and reduced re-hospitalization days. A combination of vocational and residential services is related to a synergistic decrease in re-hospitalization days. This suggests that recurrent hospitalization for patients who are using PRS is shorter and may be part of their recovery pathway.
精神康复对于精神分裂症患者的康复至关重要。然而，再次住院有时不可避免。本研究探讨了各种社区精神康复服务（PRS）与长期再次住院参数之间的关联。国家登记处提供了5163名被诊断患有精神分裂症和分裂情感性障碍的成年人的数据。对反复住院的患者进行了三个阶段的跟踪：康复立法前（1991 - 2000年）、康复实施期间（2001 - 2009年）和随访期（2010 - 2017年）。分析了PRS类型与随访期间年度再次住院天数（ARHD）之间的关联。研究结果显示，康复组的再次入院中位时间为757天，而非康复组为321天。综合住宿和职业康复与ARHD减少20天相关，而单独的住宿或职业康复分别与减少2天和5天相关。更高水平的住宿支持与ARHD减少有关。在职业康复类型中，支持性就业和庇护工场与ARHD减少最多（17天）相关。总体而言，基于社区的PRS与延长再次入院时间和减少再次住院天数相关。职业和住宿服务的结合与再次住院天数的协同减少有关。这表明使用PRS的患者再次住院时间较短，可能是其康复途径的一部分。
