Healthcare resource use in schizophrenia, EuroSC findings

Abstract

Background: It is unclear if the burden associated with schizophrenia is affected by the type and severity of patient’s symptoms. Objective: This study aims to quantify healthcare resource use associated with different profiles of schizophrenia symptoms. Study design: Post-hoc analysis of data from a naturalistic follow-up study. Setting: Secondary psychiatric services in France, Germany and the UK. Patients: EuroSC cohort:, representative sample of 1,208 schizophrenia patients Main outcome measure: We classified patients into eight health states, according to the Lenert classification (HS1–HS8), and estimated 6-month healthcare resource use (outpatient and day clinic visits, and hospitalisations) across the health states. Results: Approximately half of the patients were classed as having mild symptoms (HS1), with around 20% experiencing moderate, predominantly negative symptoms (HS2). The remaining health states were represented by <10% of patients each. Very few patients experienced extremely severe symptoms (HS8). No health state was associated with excess utilisation across all resource types. In terms of outpatient visits, patients were estimated to see a psychiatrist most often (3.01–4.15 visits over 6 months). Hospital admission was needed in 11%(HS1) – 35%(HS8) of patients and inpatient stays were generally prolonged for all health states (39–57 days). The average number of inpatient days was highest for patients in HS8 (18.17 days), followed by patients with severe negative symptoms (HS4; 13.37 days). In other health states characterised by severe symptoms (HS5–HS7), the average number of inpatient days was approximately half of those seen for HS4 (6.09–7.66). Conclusion: While none of the symptom profiles was associated with excess resource usage, hospitalization days were highest for HS with severe, predominantly negative or extremely severe symptoms. Patients with predominantly negative, moderate or severe symptoms appeared to have a high number of psychologist visits – an interesting finding that may reflect a specific therapeutic approach to the treatment of these patients.

Epidemiology of schizophrenia and its management over 8-years period using real-world data in Spain

“…Regarding hospitalizations, the median LOS of hospitalizations encoded with a SD diagnosis associated (21095) was 4 days, whereas our average LOS was 10 days (data not shown). Although these results are comparable to other European studies [43][44][45], the average LOS of acute psychotic episodes may be longer [46]. The fact that we considered hospitalizations for SD in any diagnosis position could have influenced these estimates.…”

Analysis of psychiatric services for patients diagnosed with schizophrenia, reported to the National Health Fund in the years 2009–2018

“…According to the WHO data [41], the longest lengths of hospitalization of schizophrenia patients were reported in the United Kingdom (132 days on average), the Czech Republic (89 days), Finland (71 days), and Poland (45 days), while the shortest lengths of stay were recorded in Denmark (6 days). In a study conducted in France, Germany and the United Kingdom, the length of hospitalization ranged from 39 to 57 days [27]. In Poland, the average length of hospitalization in a general psychiatric ward was 43 days in 2018, which is more than the EU estimated average of 38.5 days [42].…”

“…Millier et al [27] analyzed access to healthcare resources in France, Germany and the United Kingdom by patients diagnosed with schizophrenia (1208 persons) every 6 months over a period of 2 years. The authors took into consideration different types of services, including psychiatric consultation, psychologist consultation, day-care treatment, and days of hospitalization.…”

Negative Symptoms of Schizophrenia: Constructs, Burden, and Management

“…Patients with negative symptoms have been shown to use more healthcare resources (including primary care, emergency care, and specialized care visits, laboratory tests, radiology tests, and pharmaceutical prescriptions), especially with regard to primary care visits [30]. The highest direct costs are due to a high frequency of hospital admissions in negative symptom patients [49]. In addition to this direct cost, negative symptoms represent a burden for patients, caregivers, and society and therefore constitute a relevant economic burden [30].…”