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Trends on schizophrenia admissions during the deinstitutionalisation process in Spain (1980–2004)

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Abstract

Background

The deinstitutionalisation reform in Spain started after 1980 with the aim of reducing the need for hospitalisation, length of stay and the number of psychiatric hospital beds, as well as fostering psychiatric patient’s involvement in the community. The aim of this study was to review how this reform process has affected the management of schizophrenic patients from 1980 to 2004.

Methods

Longitudinal (1980–2004) study describing variables related to hospital morbidity in schizophrenia patients.

Results

Hospital admission rate has gradually increased from 1980 to 2004 from 3.71 admissions per 10,000 inhabitants to 5.89, respectively. Considering the type of admission, emergency or elective, whilst the latter has slightly decreased from 2.24 in 1980 to 1.72 in 2004, the first has almost tripled from 1.47 to 4.17. The point-prevalence of schizophrenic patients receiving inpatient treatment each year has decreased 78% in this period. Length of stay, in days per admission episode, has also decreased from 148 days in 1980 to 35 days in 2004.

Conclusion

One of the main impacts of the psychiatric health care reform in Spain has been the considerable reduction in hospital capacity devoted to schizophrenic patients, based on the significant decrease in point-prevalence. Thus, it seems relevant to design new studies to quantify the resource reallocation to other areas of care, such as pharmacological treatment and community services.

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Acknowledgments

We thank Dr. Juan Carlos García Gutierrez and Dr. Alberto Fernández Líria (Hospital Universitario de Puerto Real and Hospital Príncipe de Asturias of Alcalá de Henares, respectively) for their comments on clinical management and Mr. Raimundo Alcázar Alcázar for carrying out the literature search in preparation for this study. Funding for this study was partially provided by a grant from the National R&D Plan (PIO6/90571).

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Authors and Affiliations

  1. Instituto de Salud Carlos III, Madrid, Spain

    Zuleika Saz-Parkinson, A. Medel, P. Cediel-García, J. Castellote, C. Bouza & J. M. Amate

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  1. Zuleika Saz-Parkinson
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  2. A. Medel
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  3. P. Cediel-García
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  4. J. Castellote
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Correspondence to Zuleika Saz-Parkinson.

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Saz-Parkinson, Z., Medel, A., Cediel-García, P. et al. Trends on schizophrenia admissions during the deinstitutionalisation process in Spain (1980–2004). Soc Psychiatry Psychiatr Epidemiol 46, 1095–1101 (2011). https://doi.org/10.1007/s00127-010-0289-9

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