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Differential Effect of Community Rehabilitation Reform on Hospitalizations of Patients with Chronic Psychotic Disorders With and Without Substance Use Disorder, Israel, 1991-2016.
Adm Policy Ment Health. 2021 03; 48(2):354-362.AP

Abstract

The co-occurrence of schizophrenia and substance use disorder (SUD) is clinically challenging and increasingly prevalent. This study compares trends in hospitalization characteristics of chronic psychotic patients with and without SUD in Israel, before and after introduction of the Community Rehabilitation of Persons with Mental Disability Law in 2000. The National Psychiatric Case Registry provided data on 18,684 adults with schizophrenia/schizoaffective disorders, hospitalized in 1991-2016 (at least once in 2010-2015). Repeated-measures ANOVA was used to measure the effect (and interactions) of group (patients with and without co-occurring disorders (COD)), time-period (Period1: 1991-2000, Period2: 2001-2009, Period3: 2010-2016) and age, on hospitalization measures-average length of stay (LOS), annual number of hospitalizations and hospitalization days. Among non-COD patients hospitalized in all three periods, LOS declined by half from 133.3 days in Period1 to 63.2 in Period3, and the annual number of hospitalizations increased slightly from 0.45 to 0.56. Among COD patients, LOS declined moderately from 82.7 days to 58.3 days, while annual hospitalizations increased dramatically from 0.56 to 0.82. The annual average number of hospitalization days/capita declined from 49.7 in Period1 to 26.3 in Period3 among non-COD patients, yet remained virtually unchanged among COD patients-39.6 and 37.4 in the two periods, respectively. Since introduction of the law, a significant improvement in hospitalization characteristics of chronic psychotic non-COD patients has been noted, whereas the situation worsened somewhat for COD patients. Community rehabilitation services for COD patients in Israel have yet to develop as a suitable alternative to hospitalization, and additional rehabilitation services are urgently needed.

Authors+Show Affiliations

Faculty of Medicine, The Hebrew University of Jerusalem, P.O. Box 12272, 9112102, Jerusalem, Israel. sharonflorentin@gmail.com.Hebrew University-Hadassah Braun School of Public Health & Community Medicine, The Hebrew University of Jerusalem, Jerusalem, Israel.Jerusalem Mental Health Center Affiliated with The Hebrew University of Jerusalem, Jerusalem, Israel.Faculty of Medicine, The Hebrew University of Jerusalem, Jerusalem, Israel.Department for the Treatment of Substance Abuse, Ministry of Health, Jerusalem, Israel. The Hebrew University of Jerusalem, Jerusalem, Israel.

Pub Type(s)

Journal Article

Language

eng

PubMed ID

32780219

Citation

Florentin, S, et al. "Differential Effect of Community Rehabilitation Reform On Hospitalizations of Patients With Chronic Psychotic Disorders With and Without Substance Use Disorder, Israel, 1991-2016." Administration and Policy in Mental Health, vol. 48, no. 2, 2021, pp. 354-362.
Florentin S, Neumark Y, Raskin S, et al. Differential Effect of Community Rehabilitation Reform on Hospitalizations of Patients with Chronic Psychotic Disorders With and Without Substance Use Disorder, Israel, 1991-2016. Adm Policy Ment Health. 2021;48(2):354-362.
Florentin, S., Neumark, Y., Raskin, S., Bdolah-Abram, T., & Rosca, P. (2021). Differential Effect of Community Rehabilitation Reform on Hospitalizations of Patients with Chronic Psychotic Disorders With and Without Substance Use Disorder, Israel, 1991-2016. Administration and Policy in Mental Health, 48(2), 354-362. https://doi.org/10.1007/s10488-020-01077-4
Florentin S, et al. Differential Effect of Community Rehabilitation Reform On Hospitalizations of Patients With Chronic Psychotic Disorders With and Without Substance Use Disorder, Israel, 1991-2016. Adm Policy Ment Health. 2021;48(2):354-362. PubMed PMID: 32780219.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Differential Effect of Community Rehabilitation Reform on Hospitalizations of Patients with Chronic Psychotic Disorders With and Without Substance Use Disorder, Israel, 1991-2016. AU - Florentin,S, AU - Neumark,Y, AU - Raskin,S, AU - Bdolah-Abram,T, AU - Rosca,P, PY - 2020/8/12/pubmed PY - 2021/11/25/medline PY - 2020/8/12/entrez KW - Co-occurring disorders KW - LOS KW - Rehabilitation KW - SUD KW - Schizophrenia SP - 354 EP - 362 JF - Administration and policy in mental health JO - Adm Policy Ment Health VL - 48 IS - 2 N2 - The co-occurrence of schizophrenia and substance use disorder (SUD) is clinically challenging and increasingly prevalent. This study compares trends in hospitalization characteristics of chronic psychotic patients with and without SUD in Israel, before and after introduction of the Community Rehabilitation of Persons with Mental Disability Law in 2000. The National Psychiatric Case Registry provided data on 18,684 adults with schizophrenia/schizoaffective disorders, hospitalized in 1991-2016 (at least once in 2010-2015). Repeated-measures ANOVA was used to measure the effect (and interactions) of group (patients with and without co-occurring disorders (COD)), time-period (Period1: 1991-2000, Period2: 2001-2009, Period3: 2010-2016) and age, on hospitalization measures-average length of stay (LOS), annual number of hospitalizations and hospitalization days. Among non-COD patients hospitalized in all three periods, LOS declined by half from 133.3 days in Period1 to 63.2 in Period3, and the annual number of hospitalizations increased slightly from 0.45 to 0.56. Among COD patients, LOS declined moderately from 82.7 days to 58.3 days, while annual hospitalizations increased dramatically from 0.56 to 0.82. The annual average number of hospitalization days/capita declined from 49.7 in Period1 to 26.3 in Period3 among non-COD patients, yet remained virtually unchanged among COD patients-39.6 and 37.4 in the two periods, respectively. Since introduction of the law, a significant improvement in hospitalization characteristics of chronic psychotic non-COD patients has been noted, whereas the situation worsened somewhat for COD patients. Community rehabilitation services for COD patients in Israel have yet to develop as a suitable alternative to hospitalization, and additional rehabilitation services are urgently needed. SN - 1573-3289 UR - https://www.unboundmedicine.com/medline/citation/32780219/Differential_Effect_of_Community_Rehabilitation_Reform_on_Hospitalizations_of_Patients_with_Chronic_Psychotic_Disorders_With_and_Without_Substance_Use_Disorder_Israel_1991_2016_ L2 - https://doi.org/10.1007/s10488-020-01077-4 DB - PRIME DP - Unbound Medicine ER -