Long-term hospitalizations for schizophrenia in the Czech Republic 1998-2012.
Deinstitutionalization has not been pursued in the post-communist Europe until recently. The population of psychiatric patients institutionalized in the regional mental hospitals is, however, largely understudied. The aim of this study is to assess discharges of long-term inpatients with schizophrenia from Czech psychiatric hospitals and to analyse re-hospitalizations within this group. The nationwide register of all-cause inpatient hospitalizations was merged with the nationwide register of all-cause deaths on an individual level basis. Descriptive statistics, survival analysis and logistic regression were performed. 3601 patients with schizophrenia previously hospitalized for more than a year were discharged from Czech mental hospitals between 1998 and 2012. This included 260 patients hospitalized for >20years. Nearly one fifth (n=707) of the long-term patients died during the hospitalization; and discharges of 19.36% (n=697) were only administrative in their nature. Out of 2197 truly discharged patients, 14.88% (n=327) were re-hospitalized within 2weeks after the discharge. The highest odds of rehospitalization were associated with being discharged against medical advice (OR 5.27, CI: 3.77-7.35, p<0.001). These data are important for the ongoing mental health care reforms in the Czech Republic and other countries in the Central and Eastern Europe.
National Institute of Mental Health, Klecany, Czech Republic; Health Service and Population Research Department, Institute of Psychiatry, Psychology and Neuroscience, King's College London, United Kingdom. Electronic address: petr.winkler@nudz.cz.
Petr
P
Winkler
National Institute of Mental Health, Klecany, Czech Republic.
Karolína
K
Mladá
National Institute of Mental Health, Klecany, Czech Republic.
Dzmitry
D
Krupchanka
Department of Psychiatry, Clare College, University of Cambridge, United Kingdom.
Mark
M
Agius
Cambridgeshire and Peterborough NHS Foundation Trust, Cambridge, United Kingdom.
Manaan Kar
MK
Ray
National Institute of Mental Health, Klecany, Czech Republic.
Cyril
C
Höschl
D000293:Adolescent; D000328:Adult; D000368:Aged; D018153:Czech Republic / Q000453:epidemiology; D003688:Deinstitutionalization; D005260:Female; D006778:Hospitals, Psychiatric; D006801:Humans; D053208:Kaplan-Meier Estimate; D007902:Length of Stay; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D010359:Patient Readmission; D012044:Regression Analysis; D012559:Schizophrenia / Q000401:mortality / Q000628:therapy*; D055815:Young Adult
Deinstitutionalization; Epidemiology; Health service; Hospitalization; Psychiatric hospital; Schizophrenia