• Journal Article

Health care utilization and costs among Medicaid-enrolled patients with schizophrenia experiencing multiple psychiatric relapses

Citation

Karve, S., Panish, J. M., Dirani, R. G., & Candrilli, S. (2012). Health care utilization and costs among Medicaid-enrolled patients with schizophrenia experiencing multiple psychiatric relapses. Health Outcomes Research in Medicine, 3(4), e183-e194. DOI: 10.1016/j.ehrm.2012.06.003

Abstract

Objective<br>This study compared all-cause and schizophrenia-related health care utilization and costs among patients with schizophrenia using second-generation oral antipsychotics (SGOAs) and experiencing >=2 psychiatric-related relapses with those experiencing <2 relapses.<br><br>Study Design<br>Patients with schizophrenia who initiated SGOA therapy were identified in the MarketScan® Medicaid Multi-State database between July 1, 2004 and December 31, 2007. Patients were stratified by <2 psychiatric-related relapse events and >=2 psychiatric-related relapse events during the 12-month period following SGOA initiation. All-cause and schizophrenia-related health care utilization and costs were estimated for each cohort in various care settings. Univariate and multivariate regression analyses were conducted to assess the differences in all-cause and schizophrenia-related health care utilization and costs between the 2 cohorts. No adjustments were made for multiple inferential statistical tests.<br><br>Results<br>The cohort consisted of 19,813 patients, of whom 3714 (18.75%) had >=2 psychiatric-related relapse events during the follow-up period. On average, patients with >=2 psychiatric-related relapse events were younger than patients with <2 psychiatric-related relapse events (42.62 years vs. 44.21 years; P < 0.001), and the all-cause and schizophrenia-related inpatient costs were approximately 12 and 23 times higher, respectively. The mean covariate-adjusted predicted schizophrenia-related total medical costs per patient were significantly higher among patients with >=2 psychiatric-related relapse events than among patients with <2 psychiatric-related relapse events ($17,910 vs. $10,346; P < 0.001).<br><br>Conclusion<br>Patients who received an SGOA and experienced >=2 psychiatric-related relapse events within the first year of treatment incurred significantly greater all-cause and schizophrenia-related total medical costs than those with <2.