503
Views
8
CrossRef citations to date
0
Altmetric
Original Article

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

, , , , , , & show all
Pages 698-704 | Accepted 11 Oct 2010, Published online: 15 Nov 2010
 

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.

Transparency

Declaration of funding

Ortho-McNeil Janssen Scientific Affairs, LLC, funded this study.

Declaration of financial/other relationships

E.D. and E.B. have disclosed that at the time of this analysis, they were employees of Thomson Reuters, a company that was contracted by Ortho-McNeil Janssen Scientific Affairs, LLC, to conduct this study. E.M., J.C.C., R.D. and C.C. have disclosed that they are employees of Ortho-McNeil Janssen Scientific Affairs, LLC, and Johnson & Johnson stockholders. J.T.H. has disclosed that he is an employee of Johnson & Johnson Pharmaceutical Research and Development and a Johnson & Johnson stockholder. W.M. has disclosed that he was an employee of Ortho-McNeil Janssen Scientific Affairs, LLC, at the time of this analysis.

Acknowledgments

The authors wish to acknowledge the technical and editorial support provided by Matthew Grzywacz, PhD, of ApotheCom. The authors also thank Kristina Yu-Isenberg, RPh, PhD, formerly an employee of Ortho-McNeil Janssen Scientific Affairs, LLC, for her input during the conduct of this study.

Notes

*MarketScan is a registered trademark of Thomson Reuters (Healthcare) Inc.

Reprints and Corporate Permissions

Please note: Selecting permissions does not provide access to the full text of the article, please see our help page How do I view content?

To request a reprint or corporate permissions for this article, please click on the relevant link below:

Academic Permissions

Please note: Selecting permissions does not provide access to the full text of the article, please see our help page How do I view content?

Obtain permissions instantly via Rightslink by clicking on the button below:

If you are unable to obtain permissions via Rightslink, please complete and submit this Permissions form. For more information, please visit our Permissions help page.