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Health care disparities among persons with comorbid schizophrenia and cardiovascular disease: a case–control epidemiological study

Published online by Cambridge University Press:  01 October 2015

G. Gal ,
H. Munitz  and
I. Levav
G. Gal*
Affiliation:
School of Behavioral Sciences, Tel Aviv-Yaffo Academic College, Israel
H. Munitz
Affiliation:
Clalit Health Services, Tel Aviv, Israel
I. Levav
Affiliation:
Department of Community Mental Health, Faculty of Social Welfare and Health Sciences, Haifa University, Haifa, Israel
*
*Address for correspondence: G. Gal, School of Behavioral Sciences, Tel Aviv-Yaffo Academic College, Rabenu Yeruham St, Tel Aviv, Israel. (Email: giladgal@mta.ac.il)
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Abstract

Aims.

Studies showed health care disparities among persons with comorbid schizophrenia and cardiovascular disease (CVD), including in countries with universal health care. However, the potential positive effect of specific mental health legislation has not been reported. This study aimed to investigate the health care of persons with comorbid schizophrenia and CVD in a country with both a national health insurance and a comprehensive rehabilitation law for persons with mental disabilities.

Method.

This study builds on a large case–control epidemiological sample (N = 52 189) of service users. Within the sample we identified a sub-group of persons with CVD diagnoses (n = 8208) and compared service users with and without schizophrenia on drug utilisation, laboratory tests, visits to specialists and surgical interventions.

Results.

Service users with schizophrenia were less likely to meet similar indexes of care as their counterparts: 91% cholesterol tests (p < 0.001), 60% stress tests (p < 0.001), 93% visits to specialists (p = 0.001), 93% drug utilisation (p < 0.001) and 55% CVD surgical interventions (odds ratio 0.55, 95% confidence intervals 0.49–0.61).

Conclusions.

In Israel, a country with a national health insurance and a rehabilitation law specific for persons with mental disabilities, service users with schizophrenia still fail to receive equitable levels of health care for CVD. However, the disparities appear to be smaller than in other countries with universal health insurance.

Keywords

Epidemiologyhealth service researchquality of careschizophrenia
Type
Original Articles
Information
Epidemiology and Psychiatric Sciences , Volume 25 , Issue 6 , December 2016 , pp. 541 - 547
Copyright
Copyright © Cambridge University Press 2015 

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