The cost of relapse and the predictors of relapse in the treatment of schizophrenia
Open Access
- 7 January 2010
- journal article
- research article
- Published by Springer Science and Business Media LLC in BMC Psychiatry
- Vol. 10 (1), 2
- https://doi.org/10.1186/1471-244x-10-2
Abstract
To assess the direct cost of relapse and the predictors of relapse during the treatment of patients with schizophrenia in the United States. 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. 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. 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.Keywords
This publication has 26 references indexed in Scilit:
- Outpatient Antipsychotic Treatment and Inpatient Costs of SchizophreniaSchizophrenia Bulletin, 2007
- Review and analysis of hospitalization costs associated with antipsychotic nonadherence in the treatment of schizophrenia in the United StatesCurrent Medical Research and Opinion, 2007
- Mental Health In The Medicare Part D Drug Benefit: A New Regulatory Model?Health Affairs, 2006
- Cost-Effectiveness of Olanzapine as First-Line Treatment for Schizophrenia: Results from a Randomized, Open-Label, 1-Year TrialValue in Health, 2006
- Cost of disorders of the brain in EuropeEuropean Journal of Neurology, 2005
- Partial Compliance and Risk of Rehospitalization Among California Medicaid Patients With SchizophreniaPsychiatric Services, 2004
- Adherence to Treatment With Antipsychotic Medication and Health Care Costs Among Medicaid Beneficiaries With SchizophreniaAmerican Journal of Psychiatry, 2004
- Pharmacy Data Identify Poorly Adherent Patients With Schizophrenia at Increased Risk for AdmissionMedical Care, 2002
- Using Drug Claims Data to Assess the Relationship of Medication Adherence With Hospitalization and CostsPsychiatric Services, 2001
- A New Depression Scale Designed to be Sensitive to ChangeThe British Journal of Psychiatry, 1979