The costs of schizophrenia and predictors of hospitalisation from the statutory health insurance perspective
Creators: name: Zeidler, Jan
name: Slawik, Lara
name: Fleischmann, Jochen
name: Greiner, Wolfgang
Publisher: name: Heidelberg : Springer Verlag
Year: 2012
Subjects: subject: Claims data; Costs; Germany; Hospitalisation; Predictors; Schizophrenia
subject: adult; article; comorbidity; controlled study; cost of illness; female; health care cost; health insurance; hospital cost; hospitalization; human; major clinical study; male; prediction; priority journal; rehabilitation care; schizophrenia; sex difference; substance abuse
subject: Costs
subject: Germany
subject: Hospitalisation
subject: Predictors
subject: Schizophrenia
subject: comorbidity
subject: controlled study
subject: cost of illness
subject: female
subject: health care cost
subject: health insurance
subject: hospital cost
subject: hospitalization
subject: major clinical study
subject: male
subject: prediction
subject: priority journal
subject: rehabilitation care
subject: schizophrenia
subject: sex difference
subject: substance abuse
subject: Dewey Decimal Classification::300 | Sozialwissenschaften, Soziologie, Anthropologie::330 | Wirtschaft
subject: Dewey Decimal Classification::600 | Technik::610 | Medizin, Gesundheit

description: Background: The aim of the study was to determine the costs of treating schizophrenia from the perspective of the statutory health insurance, as well as the identification of predictors of hospitalisation of formerly stable schizophrenia patients. Methods: Claims data for the years 2004-2006 were analysed. Patients who did not have to be treated in a hospital as a result of an ICD diagnosis F20 both in the year 2005 as well as also in 2006 were defined as stable patients. In contrast, those patients who had to be treated in a hospital in 2006 because of a diagnosis of schizophrenia were defined as unstable. In addition to the overall healthcare costs, the costs specific to schizophrenia were also analysed. Also, based on binary logistic regression analysis, predictors for hospital treatment were determined. Results: 8497 stable and 1449 unstable patients were identified. The schizophrenia specific costs for stable patients were € 1605 and the overall costs were €4029 in 2006, respectively. Unstable patients had indication-specific costs amounting to € 12864 and overall health care costs of € 16824. For unstable patients, the costs of hospital treatment were identified as being a substantial cost area. Predictors for a higher probability of hospital treatment were: female patients, at least one rehabilitation measure, at least one stay in hospital in 2004, and being co-morbid with substance abuse. In contrast, older patients, who were treated with concomitant medications, and if they received a continuous drug therapy in all quarters of a year had a lower probability of hospitalisation. In addition, an increased number of visits to a doctor reduced the probability of hospitalisation. The variable 'depot medication' were close to significance and the variable inability to work lasting more than six weeks' had, in contrast, no significant influence.Conclusions: The schizophrenia specific and overall health care costs of unstable patients were clearly higher than was the case with stable patients and mainly determined by inpatient hospital treatment. A range of potential predicting factors which can be extracted from routine claims data have a positive or negative influence on the probability of treatment in hospital.