Most studies of healthcare provision for patients with mental illness usually focus on psychological problems but often ignore physical disease. Jen-Huoy Tsay and colleagues at the National Yang Ming University, Taipei, Taiwan, R.O.C., have compared the outcomes of appendicitis sufferers, looking specifically at patients with and without mental illness, including schizophrenia and different major mental illnesses.
The team used Taiwanese National Health Insurance (NHI) hospital-discharge data and compared the likelihood of a ruptured appendix among almost 100,000 people aged 15 and over who were hospitalized for acute appendicitis in Taiwan during the period 1997-2001
Tsay and colleagues found that a ruptured appendix occurred in 46.7 percent of the schizophrenic patients, in 43.4 percent of the patients with other major mental disorders, and in 25.1 percent of the patients with no major mental diseases. More ruptured cases were found among males and older patients.
After adjusting for age, gender, ethnicity, socioeconomic background, and hospital characteristics, the team found that patients with schizophrenia were still almost three times as likely to suffer a ruptured appendix as the general population. The presence of affective psychoses or other major mental disorders did not, however, remain associated with a significantly increased risk of rupture.
The findings suggest that, even though the NHI program reduces financial barriers to care for people with mentally illness, schizophrenics are still at a disadvantage in obtaining timely treatment for physical problems.
Disparities in Appendicitis Rupture Rate among Mentally Ill Patients Jen-Huoy Tsay, Cheng-Hua Lee, Yea-Jen Hsu, Pen-Jen Wang, Ya-Mei Bai, Yiing-Jenq Chou and Nicole Huang
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