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[THE SCHIZOPHRENIC PATIENT IN THE DEPARTMENT OF MEDICINE IN THE 21ST CENTURY: IS THERE ANYTHING NEW UNDER THE SUN?]
Einat Mader1, Naama Schwartz2, Itamar Minuhin3
1Department of Psychiatry, Emek Medical Center, Afula.
Introduction:
A retrospective analysis of information from the computerized data of the Emek Medical Center (EMC) and Clalit Community Healthcare Services (CCHS) was conducted. Two hundred and seventy-five SPs and four hundred and twenty eight NPPs were enrolled in the study.
Aims:
Patients returning to the emergency room, and re-hospitalizations in the internal medicine wards.
Background:
Schizophrenic patients (SPs) are at risk for organic co-morbidities and tend to be excessively hospitalized in medical departments. It is important to understand the pattern of SP re-admissions to emergency rooms and medical departments in order to avoid re-hospitalizations.
Objectives:
To compare re-admissions to medical emergency rooms and medical departments between SP and non-psychiatric patients (NPPs) and to assess the changes that took place during the years 2001-2011.
Results:
The likelihood that SPs would be referred to the ER during the first 6 months after discharge was 1.51 (95% CI 1.10-2.07), higher than in NPPs. The likelihood of being re-hospitalized in medical departments during the first 6 months after discharge was higher in SPs but did not reach statistical significance (26.18% among SPs vs.20.09% among NPPs (P = 0.059). The time from the index hospitalization to re-hospitalization during the first year was shorter in the SPs when compared with NPPs (P=0.0032).
Conclusions:
Medical patients with schizophrenia tend to be referred to the medical emergency room and to be re-hospitalized after their index hospitalization. The integration of medical and psychiatric systems may improve their medical care and reduce their re-admission rates.
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