TY - JOUR
T1 - Costs of treating patients with schizophrenia who have illness-related crisis events
AU - Zhu, Baojin
AU - Ascher-Svanum, Haya
AU - Faries, Douglas E.
AU - Peng, Xiaomei
AU - Salkever, David
AU - Slade, Eric P.
N1 - Funding Information:
Financial support for this research was provided by a grant from Eli Lilly and company. The authors also wish to thank the US-SCAP site investigators and others who collaborated in the research. By site, they include Maryland: A. F. Lehman, M.D., M.S.P.H., University of Maryland School of Medicine, and G. Gallucci, M.D., M.H.S., Johns Hopkins Bayview Medical Center (previously); Colorado: C. Harding, Ph.D., University of Colorado (previously); Florida: D. Shern, Ph.D., Florida Mental Health Institute, University of South Florida (previously), and T. Saunders, M.S., Florida Mental Health Institute (previously); North Carolina: J. Swanson, Ph.D., L. A. Dunn, M.D., and M. Swartz, M.D., Duke University Medical School; California: R. L. Hough, Ph.D., and C. Barrio, Ph.D., Child and Adolescent Services Research Center and San Diego State University; Connecticut: R. A. Rosenheck, M.D., and R.
PY - 2008/8/26
Y1 - 2008/8/26
N2 - Background: Relatively little is known about the relationship between psychosocial crises and treatment costs for persons with schizophrenia. This naturalistic prospective study assessed the association of recent crises with mental health treatment costs among persons receiving treatment for schizophrenia. Methods: Data were drawn from a large multi-site, non-interventional study of schizophrenia patients in the United States, conducted between 1997 and 2003. Participants were treated at mental health treatment systems, including the Department of Veterans Affairs (VA) hospitals, community mental health centers, community and state hospitals, and university health care service systems. Total costs over a 1-year period for mental health services and component costs (psychiatric hospitalizations, antipsychotic medications, other psychotropic medications, day treatment, emergency psychiatric services, psychosocial/ rehabilitation group therapy, individual therapy, medication management, and case management) were calculated for 1557 patients with complete medical information. Direct mental health treatment costs for patients who had experienced 1 or more of 5 recent crisis events were compared to propensity-matched samples of persons who had not experienced a crisis event. The 5 non-mutually exclusive crisis event subgroups were: suicide attempt in the past 4 weeks (n = 18), psychiatric hospitalization in the past 6 months (n = 240), arrest in the past 6 months (n = 56), violent behaviors in the past 4 weeks (n = 62), and diagnosis of a co-occurring substance use disorder (n = 413). Results: Across all 5 categories of crisis events, patients who had a recent crisis had higher average annual mental health treatment costs than patients in propensity-score matched comparison samples. Average annual mental health treatment costs were significantly higher for persons who attempted suicide ($46,024), followed by persons with psychiatric hospitalization in the past 6 months ($37,329), persons with prior arrests ($31,081), and persons with violent behaviors ($18,778). Total cost was not significantly higher for those with co-occurring substance use disorder ($19,034). Conclusion: Recent crises, particularly suicide attempts, psychiatric hospitalizations, and criminal arrests, are predictive of higher mental health treatment costs in schizophrenia patients.
AB - Background: Relatively little is known about the relationship between psychosocial crises and treatment costs for persons with schizophrenia. This naturalistic prospective study assessed the association of recent crises with mental health treatment costs among persons receiving treatment for schizophrenia. Methods: Data were drawn from a large multi-site, non-interventional study of schizophrenia patients in the United States, conducted between 1997 and 2003. Participants were treated at mental health treatment systems, including the Department of Veterans Affairs (VA) hospitals, community mental health centers, community and state hospitals, and university health care service systems. Total costs over a 1-year period for mental health services and component costs (psychiatric hospitalizations, antipsychotic medications, other psychotropic medications, day treatment, emergency psychiatric services, psychosocial/ rehabilitation group therapy, individual therapy, medication management, and case management) were calculated for 1557 patients with complete medical information. Direct mental health treatment costs for patients who had experienced 1 or more of 5 recent crisis events were compared to propensity-matched samples of persons who had not experienced a crisis event. The 5 non-mutually exclusive crisis event subgroups were: suicide attempt in the past 4 weeks (n = 18), psychiatric hospitalization in the past 6 months (n = 240), arrest in the past 6 months (n = 56), violent behaviors in the past 4 weeks (n = 62), and diagnosis of a co-occurring substance use disorder (n = 413). Results: Across all 5 categories of crisis events, patients who had a recent crisis had higher average annual mental health treatment costs than patients in propensity-score matched comparison samples. Average annual mental health treatment costs were significantly higher for persons who attempted suicide ($46,024), followed by persons with psychiatric hospitalization in the past 6 months ($37,329), persons with prior arrests ($31,081), and persons with violent behaviors ($18,778). Total cost was not significantly higher for those with co-occurring substance use disorder ($19,034). Conclusion: Recent crises, particularly suicide attempts, psychiatric hospitalizations, and criminal arrests, are predictive of higher mental health treatment costs in schizophrenia patients.
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U2 - 10.1186/1471-244X-8-72
DO - 10.1186/1471-244X-8-72
M3 - Article
C2 - 18727831
AN - SCOPUS:51949108502
SN - 1471-244X
VL - 8
JO - BMC psychiatry
JF - BMC psychiatry
M1 - 72
ER -