title: Health care disparities among persons with comorbid schizophrenia and cardiovascular disease: a case-control epidemiological study.
abstract: OBJECTIVE
  Studies showed health care disparities among persons with comorbid schizophrenia and cardiovascular disease (CVD), including in countries with universal health care. However, the potential positive effect of specific mental health legislation has not been reported. This study aimed to investigate the health care of persons with comorbid schizophrenia and CVD in a country with both a national health insurance and a comprehensive rehabilitation law for persons with mental disabilities.
  
  
  METHODS
  This study builds on a large case-control epidemiological sample (N = 52 189) of service users. Within the sample we identified a sub-group of persons with CVD diagnoses (n = 8208) and compared service users with and without schizophrenia on drug utilisation, laboratory tests, visits to specialists and surgical interventions.
  
  
  RESULTS
  Service users with schizophrenia were less likely to meet similar indexes of care as their counterparts: 91% cholesterol tests (p < 0.001), 60% stress tests (p < 0.001), 93% visits to specialists (p = 0.001), 93% drug utilisation (p < 0.001) and 55% CVD surgical interventions (odds ratio 0.55, 95% confidence intervals 0.49-0.61).
  
  
  CONCLUSIONS
  In Israel, a country with a national health insurance and a rehabilitation law specific for persons with mental disabilities, service users with schizophrenia still fail to receive equitable levels of health care for CVD. However, the disparities appear to be smaller than in other countries with universal health insurance.
authors.affiliation: School of Behavioral Sciences,Tel Aviv-Yaffo Academic College,Israel.
authors.forename: G
authors.initials: G
authors.lastname: Gal
authors.affiliation: Clalit Health Services,Tel Aviv,Israel.
authors.forename: H
authors.initials: H
authors.lastname: Munitz
authors.affiliation: Department of Community Mental Health,Faculty of Social Welfare and Health Sciences,Haifa University,Haifa,Israel.
authors.forename: I
authors.initials: I
authors.lastname: Levav
mesh_terms: D000328:Adult; D002318:Cardiovascular Diseases / Q000150:complications* / Q000628:therapy; D016021:Epidemiologic Studies; D054625:Healthcare Disparities; D006801:Humans; D007557:Israel; D009313:National Health Programs; D012559:Schizophrenia / Q000150:complications* / Q000628:therapy
keywords: Epidemiology; health service research; quality of care; schizophrenia