The Effects of Community Rehabilitation Models on Health Services Utilization among Patients with Schizophrenia in Taiwan
Date Issued
2011
Date
2011
Author(s)
Wu, Hsi-Wen
Abstract
Community mental health care model has become the mainstream of the treatment in patients with chronic mental health illness among the world. According to the literature reviews, the proportion of the utilization of psychiatric community rehabilitation services in Taiwan was relative lower than that of the other countries. Reseacher would like to investigate whether the treatment of community rehabilitation services for patients with schizophrenia could decline the health services utilization after admission, and to evaluate that the community rehabilitation models is still needed to be expanded, strengthen or encouraged to referral. The aim of this research was to investigate the effects of health services utilization among patients with schizophrenia after 1 and 2 years treatment in the community rehabilitation (including models of community rehabilitation center, half-way house, and day care center). This research also investigated the effects of health services utilization after 1 and 2 years treatment in the community rehabilitation among patients with schizophrenia when the different length of treatment or cross-section to receive the treatment.
We included 203 patients discharged from psychiatric hospitalization within 1 year continuously treatment for more than 30 days in community rehabilitation centers, 196 patients treatment for more than 30 days in half-way houses, and 203 patients treatment for more than 30 days in day care centers. We also included 1631 patients discharged from psychiatric hospitalization within 1 year and only receive psychiatric outpatient follow-up. Data were analyzed by using descriptive method, χ2 test, t-test, multiple regression, and difference in difference method. In order to reduce selection bias, the researchers used propensity score method to balance the covariates.
The results revealed that, compared with patients who received only psychiatric outpatient treatment, patients who received treatment from day care centers had lower non-psychiatric inpatient health services utilization after 1-year follow-up. Patients who received treatment from community rehabilitation centers had lower acute psychiatric inpatient health services utilization after 1 and 2-year follow-up. Patients who received treatment from half-way houses had lower acute psychiatric inpatient health services utilization after 1-year follow-up.
Compared with patients who received 1-3 months treatment from day care centers, patients who received 4-6 months treatment from day care centers had lower acute psychiatric inpatient health services utilization after 2-year follow-up. Compared with patients who received 1-3 months treatment from community rehabilitation centers, patients who received 10-12 months treatment had lower acute and chronic psychiatric inpatient health services utilization after 2-year follow-up. Compared with patients who received 1-3 months treatment from half-way houses, patients who received 10-12 months treatment had lower chronic psychiatric inpatient health services utilization after 1-year follow-up and had lower acute and chronic psychiatric inpatient health services utilization after 2-year follow-up.
Patients received the treatment from day care centers cross-sectionally had higher chronic inpatient psychiatric medical expenditure after 1-year follow-up, and had higher numbers of chronic psychiatric hospitalization. Patients received the treatment from community rehabilitation centers cross-sectionally had higher non-psychiatric and chronic psychiatric hospitalization after 1-year follow-up, and had higher numbers of chronic psychiatric hospitalization. However, whether patients received the treatment from half-way houses cross-sectionally or not, that would not effects the health services utilization after 1 and 2-year follow-up.
Conclusion: The results indicated that compared with patients who received psychiatric outpatient follow-up, patients who received treatment over 30 days in community rehabilitation centers, half-way houses, or day care centers had lower health services utilization after 1 and 2-year follow-up.
Subjects
Patients with schizophrenia
Community rehabilitation
Propensity score
Health Services Utilization
Medical cost
SDGs
Type
thesis
File(s)![Thumbnail Image]()
Loading...
Name
ntu-100-D94843005-1.pdf
Size
23.32 KB
Format
Adobe PDF
Checksum
(MD5):0359eebdcd718f60e94badf9f0464d77