Objectives. The study was aimed at investigating, firstly, the socio-demographic factors that determine hospitalization of patients with schizophrenia, and secondly, the model of various inpatient facilities utilization in the years 1999 and 2003.
Method. The hospital-registered prevalence and incidence in sociodemographic subgroups (defined by gender, age, place of residence), as well as the structure of hospitalization in various inpatient psychiatric facilities were analyzed.
Results. The hospitalization prevalence among previously treated patients did not change between the years 1999 and 2003, while the registered incidence increased by 14%. The mean duration of inpatient treatment decreased by 7%. In both these years the diagnosis ofparanoid schizophrenia predominated (62 and 70%, respectively). The highest rates of hospitalization prevalence were found in the age group 36-50years (150per 100.000population). First admissions were most frequent in the 20-35 age range, being earlier in males. Men are more often hospitalized than women, and the difference was even more marked after the five years. The duration of inpatient treatment was longer in men than in women, and in the year 2003 this difference was smaller than 5 years earlier. Urban area residents were hospitalized more often than those from rural areas, and the inpatient treatment duration was shorter in the former group. These differences were more pronounced at the 5-year follow-up.
Conclusions. The analyses suggest that rural area residents are admitted to psychiatric facilities later, when their condition is more severe, and so they need longer treatment. These findings should be taken under consideration by psychiatric care managers. The model of psychiatric care utilization in the year 2003 differed from that noted 5 years earlier. From the viewpoint of the health policy postulated by the Mental Health Programme, the changes are twofold: some are beneficial (e.g. less patients are treated in general wards of mental hospitals, and more receive treatment in psychiatric wards at general hospitals), while other changes are disadvantageous. Namely, according to the Programme more patients should be treated in specialist psychiatric facilities. However, the utilization of such units as those providing psychiatric rehabilitation, or care for long-term patients, has decreased. The only exception was the use of one type of specialist unit, i.e. nursing-treatment residential facility, which was found to be increased. Moreover, no hostels came into existence.