Re-hospitalization of first-in-life admitted schizophrenic patients before and after rehabilitation legislation: a comparison of two national cohorts.

BACKGROUND: In line with the worldwide trend of deinstitutionalization and development of community facilities, a rehabilitation legislation was passed in Israel in 2000. Its aim was to establish an infrastructure for the chronic mentally ill. The objective of the present study was to evaluate the impact of this legislation on the re-hospitalization of schizophrenic patients. METHOD: Re-hospitalization rates within 3 years of discharge were compared for two cohorts of first-in-life hospitalized schizophrenics, those discharged in 1990-1991 and those discharged in 2000-2001, after the passing of the law. Possible confounding variables were controlled for by logistic regression analyses. The same analysis was done for patients with affective disorders who are not generally beneficiaries of this legislation. RESULTS: In 2000-2001, the re-hospitalization rate was significantly lower than in 1990-1991 for schizophrenic patients with an in-patient stay longer than 6 months (chronic patients) but not for short-stay schizophrenics or for affective patients. CONCLUSION: The study suggests that the expanding of the rehabilitation facilities in the community by legislation leads to increase in the survival in the community of schizophrenic patients.