The readmission rate and medical cost of patients with schizophrenia after first hospitalization — A 10-year follow-up population-based study

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• 作者：Mei Hung Chi^a ; Chih Yin Hsiao^a ; Kao Chin Chen^a ; ^b ; Lan-Ting Lee^a ; Hsin Chun Tsai^a ; ^c ; I Hui Lee^a ; ^b ; ^c ; Po See Chen^a ; ^b ; Yen Kuang Yang^a ; ^b ; ^c ; ^d ; ^{ykyang@mail.ncku.edu.tw" class="auth_mail" title="E-mail the corresponding author}
• 关键词：First hospitalization ; Medical cost ; Readmission ; Schizophrenia ; Service utilization
• 刊名：Schizophrenia Research
• 出版年：2016
• 出版时间：January 2016
• 年：2016
• 卷：170
• 期：1
• 页码：184-190
• 全文大小：526 K

文摘

Hospital readmissions caused by relapse in patients with schizophrenia are associated with prognosis. Identifying individuals at high risk of readmission and providing interventions to lower the readmission rate are important.

Methods

Patients with schizophrenia who were hospitalized for the first time were recruited from the National Health Insurance Research Database from 2001 to 2010 (n = 808, mean age 28.9 years) and compared with matched controls. Data on the demographics, cost, and utilization of medical resources of patients who were readmitted were compared with non-readmitted patients. The readmission time curve was analyzed by the Kaplan–Meier method.

Result

570 (70.5%) patients were readmitted within 10 years; the median time between admissions was 1.9 years, and 25% of subjects were readmitted within 4 months of the first hospitalization. There were no significant differences in age, gender, or length of hospitalization between the readmission and non-readmission groups. Taking into account all psychiatric medical services, the readmission group had a significantly higher mean frequency of care and a greater medical cost than the non-readmission group and matched controls. However, there were no significant differences with regard to non-psychiatric medical services.

Conclusion

Schizophrenia has a high rate of readmission and high medical cost in naturalistic settings. In addition to the traditional hospital-based treatment model for patients with schizophrenia, the development of an effective intervention program is important, especially in the early years of the disease.