The cost of relapse and the predictors of relapse in the treatment of schizophrenia

Haya Ascher-Svanum, Baojin Zhu, Douglas E. Faries, David S Salkever, Eric Slade, Xiaomei Peng, Robert R. Conley

Research output: Contribution to journalArticle

Abstract

Background: To assess the direct cost of relapse and the predictors of relapse during the treatment of patients with schizophrenia in the United States.Methods: Data were drawn from a prospective, observational, noninterventional study of schizophrenia in the United States (US-SCAP) conducted between 7/1997 and 9/2003. Patients with and without relapse in the prior 6 months were compared on total direct mental health costs and cost components in the following year using propensity score matching method. Baseline predictors of subsequent relapse were also assessed.Results: Of 1,557 participants with eligible data, 310 (20%) relapsed during the 6 months prior to the 1-year study period. Costs for patients with prior relapse were about 3 times the costs for patients without prior relapse. Relapse was associated with higher costs for inpatient services as well as for outpatient services and medication. Patients with prior relapse were younger and had onset of illness at earlier ages, poorer medication adherence, more severe symptoms, a higher prevalence of substance use disorder, and worse functional status. Inpatient costs for patients with a relapse during both the prior 6 months and the follow-up year were 5 times the costs for patients with relapse during the follow-up year only. Prior relapse was a robust predictor of subsequent relapse, above and beyond information about patients' functioning and symptom levels.Conclusions: Despite the historical decline in utilization of psychiatric inpatient services, relapse remains an important predictor of subsequent relapse and treatment costs for persons with schizophrenia.

Original languageEnglish (US)
Article number2
JournalBMC Psychiatry
Volume10
DOIs
StatePublished - Jan 7 2010
Externally publishedYes

Fingerprint

Schizophrenia
Costs and Cost Analysis
Recurrence
Therapeutics
Inpatients
Health Care Costs
Propensity Score
Medication Adherence
Ambulatory Care
Substance-Related Disorders
Observational Studies
Psychiatry
Mental Health

ASJC Scopus subject areas

  • Psychiatry and Mental health

Cite this

The cost of relapse and the predictors of relapse in the treatment of schizophrenia. / Ascher-Svanum, Haya; Zhu, Baojin; Faries, Douglas E.; Salkever, David S; Slade, Eric; Peng, Xiaomei; Conley, Robert R.

In: BMC Psychiatry, Vol. 10, 2, 07.01.2010.

Research output: Contribution to journalArticle

Ascher-Svanum, Haya ; Zhu, Baojin ; Faries, Douglas E. ; Salkever, David S ; Slade, Eric ; Peng, Xiaomei ; Conley, Robert R. / The cost of relapse and the predictors of relapse in the treatment of schizophrenia. In: BMC Psychiatry. 2010 ; Vol. 10.
@article{19ca7783271040c7b84ec7c1b783c17b,
title = "The cost of relapse and the predictors of relapse in the treatment of schizophrenia",
abstract = "Background: To assess the direct cost of relapse and the predictors of relapse during the treatment of patients with schizophrenia in the United States.Methods: Data were drawn from a prospective, observational, noninterventional study of schizophrenia in the United States (US-SCAP) conducted between 7/1997 and 9/2003. Patients with and without relapse in the prior 6 months were compared on total direct mental health costs and cost components in the following year using propensity score matching method. Baseline predictors of subsequent relapse were also assessed.Results: Of 1,557 participants with eligible data, 310 (20{\%}) relapsed during the 6 months prior to the 1-year study period. Costs for patients with prior relapse were about 3 times the costs for patients without prior relapse. Relapse was associated with higher costs for inpatient services as well as for outpatient services and medication. Patients with prior relapse were younger and had onset of illness at earlier ages, poorer medication adherence, more severe symptoms, a higher prevalence of substance use disorder, and worse functional status. Inpatient costs for patients with a relapse during both the prior 6 months and the follow-up year were 5 times the costs for patients with relapse during the follow-up year only. Prior relapse was a robust predictor of subsequent relapse, above and beyond information about patients' functioning and symptom levels.Conclusions: Despite the historical decline in utilization of psychiatric inpatient services, relapse remains an important predictor of subsequent relapse and treatment costs for persons with schizophrenia.",
author = "Haya Ascher-Svanum and Baojin Zhu and Faries, {Douglas E.} and Salkever, {David S} and Eric Slade and Xiaomei Peng and Conley, {Robert R.}",
year = "2010",
month = "1",
day = "7",
doi = "10.1186/1471-244X-10-2",
language = "English (US)",
volume = "10",
journal = "BMC Psychiatry",
issn = "1471-244X",
publisher = "BioMed Central",

}

TY - JOUR

T1 - The cost of relapse and the predictors of relapse in the treatment of schizophrenia

AU - Ascher-Svanum, Haya

AU - Zhu, Baojin

AU - Faries, Douglas E.

AU - Salkever, David S

AU - Slade, Eric

AU - Peng, Xiaomei

AU - Conley, Robert R.

PY - 2010/1/7

Y1 - 2010/1/7

N2 - Background: To assess the direct cost of relapse and the predictors of relapse during the treatment of patients with schizophrenia in the United States.Methods: Data were drawn from a prospective, observational, noninterventional study of schizophrenia in the United States (US-SCAP) conducted between 7/1997 and 9/2003. Patients with and without relapse in the prior 6 months were compared on total direct mental health costs and cost components in the following year using propensity score matching method. Baseline predictors of subsequent relapse were also assessed.Results: Of 1,557 participants with eligible data, 310 (20%) relapsed during the 6 months prior to the 1-year study period. Costs for patients with prior relapse were about 3 times the costs for patients without prior relapse. Relapse was associated with higher costs for inpatient services as well as for outpatient services and medication. Patients with prior relapse were younger and had onset of illness at earlier ages, poorer medication adherence, more severe symptoms, a higher prevalence of substance use disorder, and worse functional status. Inpatient costs for patients with a relapse during both the prior 6 months and the follow-up year were 5 times the costs for patients with relapse during the follow-up year only. Prior relapse was a robust predictor of subsequent relapse, above and beyond information about patients' functioning and symptom levels.Conclusions: Despite the historical decline in utilization of psychiatric inpatient services, relapse remains an important predictor of subsequent relapse and treatment costs for persons with schizophrenia.

AB - Background: To assess the direct cost of relapse and the predictors of relapse during the treatment of patients with schizophrenia in the United States.Methods: Data were drawn from a prospective, observational, noninterventional study of schizophrenia in the United States (US-SCAP) conducted between 7/1997 and 9/2003. Patients with and without relapse in the prior 6 months were compared on total direct mental health costs and cost components in the following year using propensity score matching method. Baseline predictors of subsequent relapse were also assessed.Results: Of 1,557 participants with eligible data, 310 (20%) relapsed during the 6 months prior to the 1-year study period. Costs for patients with prior relapse were about 3 times the costs for patients without prior relapse. Relapse was associated with higher costs for inpatient services as well as for outpatient services and medication. Patients with prior relapse were younger and had onset of illness at earlier ages, poorer medication adherence, more severe symptoms, a higher prevalence of substance use disorder, and worse functional status. Inpatient costs for patients with a relapse during both the prior 6 months and the follow-up year were 5 times the costs for patients with relapse during the follow-up year only. Prior relapse was a robust predictor of subsequent relapse, above and beyond information about patients' functioning and symptom levels.Conclusions: Despite the historical decline in utilization of psychiatric inpatient services, relapse remains an important predictor of subsequent relapse and treatment costs for persons with schizophrenia.

UR - http://www.scopus.com/inward/record.url?scp=76849096676&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=76849096676&partnerID=8YFLogxK

U2 - 10.1186/1471-244X-10-2

DO - 10.1186/1471-244X-10-2

M3 - Article

C2 - 20059765

AN - SCOPUS:76849096676

VL - 10

JO - BMC Psychiatry

JF - BMC Psychiatry

SN - 1471-244X

M1 - 2

ER -