Rabinowitz J, Mark M, Popper M, Feldman D
School of Social Work, Bar Ilan University, Ramat Gan, Israel.
J Ment Health Adm. 1997 Winter;24(1):82-9. doi: 10.1007/BF02790483.
Previous studies have found that although psychiatric patients tend to have more physical illness than the rest of the population, it frequently goes unrecognized and untreated in psychiatric settings. This study investigated rates of reported physical illness among hospitalized psychiatric patients in preparation for national reform in mental health services. Data from the Israeli National Psychiatric Case Registry were analyzed on reported physical illness among all 38,714 psychiatric discharges during 1989-1991. Physical illness was reported for 10.62% of patients under age 25, 14.04% of patients 25 to 44, 34.27% of patients 45 to 65, and 61.26% of patients 65 and older. Rates differed among hospitals. Reported physical illness was considerably lower than expected as compared with other studies. Underdiagnosis is suggested as a possible explanation. Study results were used to add differential payment for physical comorbidity under the new National Health Insurance Law. Other corrective measures are discussed.
以往研究发现，尽管精神病患者往往比其他人群患有更多躯体疾病，但在精神科环境中，这些疾病常常未被识别和治疗。本研究调查了住院精神病患者报告的躯体疾病发生率，为国家精神卫生服务改革做准备。对以色列国家精神病病例登记处1989 - 1991年期间所有38714例精神病出院患者报告的躯体疾病数据进行了分析。25岁以下患者中报告有躯体疾病的占10.62%，25至44岁患者中占14.04%，45至65岁患者中占34.27%，65岁及以上患者中占61.26%。不同医院的发生率有所不同。与其他研究相比，报告的躯体疾病发生率明显低于预期。提示漏诊可能是一个解释。研究结果被用于在新的《国家健康保险法》下增加对躯体共病的差别支付。还讨论了其他纠正措施。
