Health Outcomes and Cost of Care Among Older Adults with Schizophrenia: A 10-Year Study Using Medical Records across the Continuum of Care

dc.contributor.authorHendrie, Hugh C.
dc.contributor.authorTu, Wanzhu
dc.contributor.authorTabbey, Rebeka
dc.contributor.authorPurnell, Christianna E.
dc.contributor.authorAmbuehl, Roberta J.
dc.contributor.authorCallahan, Christopher M.
dc.contributor.departmentDepartment of Psychiatry, IU School of Medicineen_US
dc.date.accessioned2016-02-01T20:39:35Z
dc.date.available2016-02-01T20:39:35Z
dc.date.issued2014-05
dc.description.abstractObjectives The population of older patients with schizophrenia is increasing. This study describes health outcomes, utilization, and costs over 10 years in a sample of older patients with schizophrenia compared to older patients without schizophrenia. Design, Setting, Participants An observational cohort study of 31,588 older adults (mean age 70.44 years) receiving care from an urban public health system, including a community mental health center, during 1999–2008. 1635 (5.2%) were diagnosed with schizophrenia and 757 (2.4%) had this diagnosis confirmed in the community mental health center. Patients’ electronic medical records were merged with Medicare claims, Medicaid claims, the Minimum Dataset, and the Outcome and Assessment Information Set. Information on medication use was not available. Measurements Rates of comorbid conditions, health care utilization, costs, and mortality. Results Patients with schizophrenia had significantly higher rates of congestive heart failure (45.05% v. 38.84%), chronic obstructive pulmonary disease (52.71% v. 41.41%), and hypothyroidism (36.72% v. 26.73%) than the patients without schizophrenia (p<0.001). They had significantly lower rates of cancer (30.78% v. 43.18%) and significantly higher rates of dementia (64.46% v. 32.13%). The patients with schizophrenia had significantly higher mortality risk (HR: 1.25, CI: 1.07–1.47) than the patients without schizophrenia. They also had significantly higher rates of health care utilization. The mean costs for Medicare and Medicaid were significantly higher for the patients with schizophrenia than for the patients without schizophrenia. Conclusions The management of older adult patients with schizophrenia is creating a serious burden for our health care system, requiring the development of integrated models of health care.en_US
dc.eprint.versionAuthor's manuscripten_US
dc.identifier.citationHendrie, H. C., Tu, W., Tabbey, R., Purnell, C. E., Ambuehl, R. J., & Callahan, C. M. (2014). Health Outcomes and Cost of Care Among Older Adults with Schizophrenia: A 10-Year Study Using Medical Records across the Continuum of Care. The American Journal of Geriatric Psychiatry : Official Journal of the American Association for Geriatric Psychiatry, 22(5), 427–436. http://doi.org/10.1016/j.jagp.2012.10.025en_US
dc.identifier.issn1064-7481en_US
dc.identifier.urihttps://hdl.handle.net/1805/8220
dc.language.isoen_USen_US
dc.publisherElsevieren_US
dc.relation.isversionof10.1016/j.jagp.2012.10.025en_US
dc.relation.journalThe American journal of geriatric psychiatry : official journal of the American Association for Geriatric Psychiatryen_US
dc.rightsPublisher Policyen_US
dc.sourcePMCen_US
dc.subjectContinuity of Patient Careen_US
dc.subjecteconomicsen_US
dc.subjectstatistics & numerical dataen_US
dc.subjectHealth Care Costsen_US
dc.subjectHealth Services for the Ageden_US
dc.subjectutilizationen_US
dc.subjectMental Health Servicesen_US
dc.subjectSchizophreniaen_US
dc.subjectdementiaen_US
dc.subjectcanceren_US
dc.titleHealth Outcomes and Cost of Care Among Older Adults with Schizophrenia: A 10-Year Study Using Medical Records across the Continuum of Careen_US
dc.typeArticleen_US
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