PMH8 A Review of Consequences of Relapse in Schizophrenia

Abstract

OBJECTIVES: With rapid ageing, prevalence of dementia in the elderly is increasing at a fast rate. This study aimed to examine the medical expenditure for dementia in the elderly and to analyze factors affecting its expenditure in South Korea. METHODS:We analyzed the data of sampled patients from National Health Insurance. Direct medical costs including hospitalization, out-patient service and pharmacy costs were calculated from claims of patients in 2010. To examine the determinants of costs, we used a two-part model to deal with the zero values of expenditure. The first part predicted the probability of any expenditure with a logistic regression while the second part used an OLS regression model with logtransformed expenditure. RESULTS: Average medical expenditure in the total of 3729 dementia patients was 5.6 million won. Average expenditure increased with severity (pϭ0.004). In the first part, patients in the long-term care facilities had a lower probability of expensing medical costs than patients with family-based care (ORϭ0.30, 95% CIϭ 0.21-0.43). The probability of incurring expenditure was much higher for severe patients than mild patients (ORϭ1.33, 95% CIϭ 1.02-1.74). Among the patients with expenditure, better educated (elementary, middle school graduates and high school graduates) spent more costs than under educated (less than elementary graduates) patients (17%, 27%, respectively) (pϽ0.05). Cost estimates demonstrated that education levels, facility care and types of dementia were significantly associated with the costs. Interestingly, the costs were 20% lower for severe patients versus mild patients because outpatient and pharmacy costs decreased as the severity increases. CONCLUSIONS: This study showed a burden of medical expenditure for dementia and associations between various factors and costs. Costs were significantly different among conditions. However, this study considered only medical costs for dementia. Therefore, further research needs to include non-medical costs and indirect costs for dementia.

The Cost of Relapse in Schizophrenia

“…With the exception of a conference presentation we found no previous literature reviewing the cost of relapse. The conference abstract reported a range from $1,198 to $50,986 across 11 studies [77]. The lower value would appear to be sourced from Daltio et al [22] and the upper value from Ascher-Svanum et al [10] for the subgroup of patients relapsing in both the observation year and the previous six months.…”