Patterns of psychiatric hospitalizations of Arab and Jewish adults with chronic psychotic disorders, before and after national mental health reforms, Israel, 1991–2016

BMC Psychiatry

Research

Yehuda Neumark¹  Paola Rosca²  Razek Haled³  Sharon Florentin⁴  Inbal Reuveni⁴ 

[1] Braun School of Public Health & Community Medicine, Faculty of Medicine, The Hebrew University of Jerusalem, Jerusalem, Israel;Department for the Treatment of Substance Abuse, Ministry of Health; The Hebrew University of Jerusalem, Jerusalem, Israel;Department of Psychiatry, Hadassah Medical Center, Jerusalem, Israel;Braun School of Public Health & Community Medicine, Faculty of Medicine, The Hebrew University of Jerusalem, Jerusalem, Israel;Department of Psychiatry, Hadassah Medical Center, Jerusalem, Israel;Faculty of Medicine, The Hebrew University of Jerusalem, Jerusalem, Israel;

关键词: Schizophrenia;    Chronic psychotic disorders;    Psychiatric hospitalization;    Arabs;    Jews;    Ethnic minority;    Sex differences;    National psychiatric registry;   

DOI  :  10.1186/s12888-023-05132-w

 received in 2023-06-15, accepted in 2023-08-23,  发布年份 2023

来源: Springer

【 摘 要 】

BackgroundMembers of the Arab minority in Israel are at increased risk of developing mental illness, although less likely to seek care and have accessible treatment. This study compares trends in psychiatric hospitalizations between Arabs and Jews with chronic psychotic disorders, before and after introduction of the Community Rehabilitation of Persons with Mental Disability Law in 2000, and governmental recognition of the need to allocate resources for patients with co-occurring substance use disorder and mental illness in 2010.MethodsThe National Psychiatric Case Registry provided data on 18,684 adults with schizophrenia/schizoaffective disorder, hospitalized in 1991–2016 (at least once in 2010–2015). Repeated-measures ANOVA was used to measure the effect (and interactions) of population-group (Arabs and Jews), time-period (Period1: 1991–2000, Period2: 2001–2009, Period3: 2010–2016) and sex, on average length of stay (LOS), annual number of hospitalizations and hospitalization days.ResultsThe proportion of Arab patients hospitalized with a diagnosis of chronic psychotic disorder (14.4%) was significantly lower than their proportion in the general population (21%), and their average age at first hospitalization (28.4 years) was older than that of Jewish inpatients (27.0 years). The average number of hospitalization days and LOS of Jewish patients were double that of Arab patients in Period1. Following implementation of the Rehabilitation Law, hospitalization days increased among Arab patients and decreased slightly among Jewish patients, such that by Period3 the average number of hospitalization days was similar among Jewish (41) and Arab (37) patients. The increase in hospitalization days among Arab patients was limited to men with no change noted among women. The number of hospitalization days among Arab women was about half that of Jewish women (p < 0.0001).ConclusionsThe findings reveal a narrowing of disparities in psychiatric hospitalizations between Arab and Jewish patients in Israel over time. However, among Arab women the number of hospitalization days remains considerably lower than that of Jewish women, raising concerns that Arab women may be receiving insufficient care. Further study is needed to fully understand the underpinnings of these disparities, although increasing the number of Arabic-language mental health services and providing psycho-education, will help further close the gap.

【 授权许可】

CC BY   
© BioMed Central Ltd., part of Springer Nature 2023

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