Format

Send to

Choose Destination
See comment in PubMed Commons below
J Med Econ. 2010;13(4):698-704. doi: 10.3111/13696998.2010.531828. Epub 2010 Nov 15.

Characteristics, healthcare utilization and costs of bipolar disorder type I patients with and without frequent psychiatric intervention in a Medicaid population.

Author information

1
Thomson Reuters, Washington, DC, USA.

Abstract

OBJECTIVE:

To compare characteristics, healthcare resource utilization and costs of Medicaid bipolar disorder (BPD) type I (BP-I) patients with and without frequent psychiatric intervention (FPI).

METHODS:

Adults with BP-I, ≥ 1 prescription claim for a mood stabilizer/atypical antipsychotic and 24 months' continuous medical/prescription coverage were identified (MarketScan* Medicaid database). Patients with ≥ 2 clinically significant events (CSEs) during a 12-month identification period had FPI. CSEs included emergency department (ED) visits or hospitalizations with a principal diagnosis of BPD, addition of a new medication to the first observed treatment regimen or ≥ 50% increase in BPD medication dose. Demographic and clinical characteristics were evaluated for the identification period, and healthcare utilization and costs for the 12-month follow-up. Multivariate generalized linear modeling and multivariate logistic regression, respectively, were used to evaluate the impact of FPI on all-cause and psychiatric-related costs and risk of psychiatric-related hospitalization and ED visit during follow-up.

RESULTS:

Of 5,527 BP-I patients, 53% had FPI. Relative to patients without FPI, those with FPI were younger and more likely to be female, had higher adjusted all-cause (+US$3,232, p < 0.001) and psychiatric-related (+US$2,519, p < 0.001) costs and higher risk of hospitalization (adjusted odds ratio [OR] = 3.681, 95% confidence interval [CI] = 2.85-4.75) and ED visit (OR = 3.094, 95% CI = 2.55-3.76).

LIMITATIONS:

Analysis used a convenience sample of Medicaid enrollees in several geographically dispersed states, limiting generalizability. Analyses of administrative claims data depend on accurate diagnoses and data entry.

CONCLUSION:

BP-I patients with FPI incurred significantly higher healthcare resource utilization and costs during the follow-up period than those without FPI.

PMID:
21073403
DOI:
10.3111/13696998.2010.531828
[Indexed for MEDLINE]
PubMed Commons home

PubMed Commons

0 comments

    Supplemental Content

    Full text links

    Icon for Taylor & Francis
    Loading ...
    Support Center