Analysis of hospital costs by morbidity group for patients with severe mental illness

Figures & data

Table 1. Patient characteristics and mean annual hospital cost by sector and total.

	Number of admissions (%)	Hospital cost^a		p Value	Hospital stays
		Mean	SD		Mean	SD
Overall	7752	9266.00	6037.60		1.9	17.5
Age				.000
0–18	567 (7.3)	8399.80	5125.10		12.5	14.5
19–24	524 (6.8)	9345.20	5464.40		12.8	15.4
25–34	1069 (13.8)	9617.70	4466.50		12.8	12.1
35–44	1609 (20.8)	9611.50	5529.40		13.3	15.9
45–54	1527 (19.7)	9800.60	6181.40		13.7	18.3
55–64	853 (11.0)	10,278.20	8592.90		15.2	26.4
65+	1603 (20.7)	7917.30	5880.10		10.7	16.8
Sex				.000
Male	3888 (50.2)	9533.00	6555.00		13.3	19.4
Female	3864 (49.8)	8997.00	5455.00		12.5	15.4
Diagnostic grouping				.000
1. Dementias and other organic mental disorders	925 (11.9)	5908.80	3585.70		8.4	10.9
2. Psychotic disorders (schizophrenia and affective psychosis)	4075 (52.6)	11,753.20	6579.00		16.5	21.1
3. Other neuroses, except depressive, anxiety disorder, sleep disorder, Sexuality Disorder	1100 (14.2)	7370.20	4592.90		9.9	12.4
4. Depressive neuroses (dysthymias)	165 (2.1)	6389.00	2229.70		7.2	7.2
5. Personality disorders and impulsivity (eating disorder)	910 (11.7)	6158.50	3240.00		9.1	10.4
6. Adaptive disorders and V codes	311 (4.0)	5966.20	2258.60		6.8	6.9
7. Childhood and adolescence disorders	157 (2.0)	6902.60	4507.10		9	13.2
8. Unspecified mental disorders	68 (0.9)	5903.00	3002.30		7	9.5
9. Surgical intervention with main diagnosis of mental disorder	41 (0.5)	8878.10	4027.00		11.5	9,7
Groups of expenditures				.000
Psychotic group	4075 (52.6)	11,753.18	6579.01		16.53	21.5
Organic group	1304 (16.8)	5922.19	3285.63		7.95	10.03
Neurotic group	2373 (30.6	6832.41	4018.02		9.38	11.41
Number of psychiatric comorbidities				.575
1	5952 (76.8)	9290.36	6273.18		12.91	18.32
2	1126 (14.5)	9276.80	5060.05		12.98	14.21
3	674 (8.7)	9032.83	5383.70		12.59	15.07
Number of total comorbidities (for the same patient)				.003
0	1183 (15.3)	9478.00	6539.40		13.2	19.1
1	1317 (17.0)	9660.50	5964.70		14	17.3
2	1198 (15.5)	9512.60	5813.60		13.2	16.8
3	1059 (13.7)	9257.60	4845.80		12.7	13.3
4	814 (10.5)	8981.90	4364.30		11.8	11.7
5	590 (7.9)	8927.80	4405.20		12.1	11.6
6 or more	1591 (20.5)	8872.50	6836.80		12.5	19.9
Abuse of substances				.367
No	5334 (68.8)	9250.40	6558.50		13.1	19.2
Yes	2418 (31.1)	9300.40	4689.10		12.4	12.9
Admission				.031
N° First admissions	6705 (86.0)	9316.60	6045.40		13	17.5
Nª Readmissions	1047 (14.0)	8942.20	5979.50		12.1	17.3
Personality disorders				.000
No	6907 (89.1)	9459.80	6142.90		13.1	17.9
Yes	845(10.9)	7682.30	4807.20		11	13.4

^aExpressed in euros.

Table 2. Principal comorbidities by ICD-9 chapter.

Comorbidities	N	%
Hypertension	1422	18.3
No comorbidity	1183	15.3
Smoking	1053	13.6
Infectious intestinal disease	960	12.4
Diabetes	840	10.8
Confusional state (Delirum^2)	718	9.3
Other disorders of consciousness	594	7.7
Metabolic disorders	516	6.7
Atrial fibrillation	465	6
Dysphagias	462	6

Table 3. Association of patient characteristics with hospital cost through regression model.

		Confidence interval
	B	Max	Min	Sig.
Psychotic group (Constant)	9.31	9.31	9.30	0.00
Organic group	−0.69	−0.68	−0.71	0.00
Neurotic group	−0.58	−0.57	−0.59	0.00
Comorbidity presence (diseases of the circulatory system)	−0.03	−0.02	−0.04	0.01
Comorbidity presence (injuries and poisonings)	0.06	0.08	0.04	0.01
Readmission	−0.03	−0.02	−0.05	0.00

Table

Coefficients^a
Model		Non standardized coefficients		Standardized coefficients	t	Sig.
		Beta	Dev. error	Beta
1	(Constant)	9234	0.022		423,029	0.000
	Gender	−0.002	0.009	−0.002	−0.226	0.821
	Substance abuse	0.036	0.010	0.034	3.748	0.000
	ConTP	−0.027	0.015	−0.017	−1.877	0.061
	Hospital readmission	−0.034	0.013	−0.024	−2.735	0.006
	Chapter 1 ICD	0.014	0.016	0.009	0.914	0.361
	Chapter 2 ICD	0.043	0.027	0.014	1.564	0.118
	Chapter 3 ICD	0.013	0.012	0.012	1.089	0.276
	Chapter 4 ICD	0.027	0.022	0.011	1.247	0.212
	Chapter 5 ICD	0.005	0.377	0.005	0.013	0.990
	Chapter 6 ICD	0.015	0.377	0.016	0.041	0.968
	Chapter 7 ICD	−0.038	0.014	−0.032	−2.756	0.006
	Chapter 8 ICD	−0.029	0.019	−0.014	−1.519	0.129
	Chapter 9 ICD	−0.011	0.017	−0.006	−0.652	0.515
	Chapter 11 ICD	0.089	0.218	0.004	0.411	0.681
	Chapter 12 ICD	−0.014	0.027	−0.005	−0.518	0.604
	Chapter 13 ICD	0.006	0.018	0.003	0.353	0.724
	Chapter 14 ICD	0.025	0.033	0.007	0.739	0.460
	Chapter 15 ICD	−0.049	0.143	−0.003	−0.343	0.731
	Chapter 16 ICD	−0.015	0.017	−0.008	−0.875	0.382
	Chapter 17 ICD	0.058	0.026	0.026	2.268	0.023
	Chapter 18 ICD	0.012	0.011	0.012	1.109	0.268
	Chapter 19 ICD	0.008	0.023	0.004	0.338	0.735
	1 psychiatric comorbidity	−0.006	0.012	−0.004	−0.459	0.646
	2 psychiatric comorbidity	−0.025	0.015	−0.016	−1.712	0.087
	3 psychiatric comorbidity	−0.007	0.012	−0.007	−0.610	0.542
	Cost group 2	−0.694	0.013	−0.529	−54.190	0.000
	Cost group 3	−0.578	0.010	−0.543	−56.527	0.000
	1 comorbidity	0.035	0.017	0.026	2.049	0.041
	2 comorbidities	0.000	0.019	0.000	−0.006	0.995
	3 comorbidities	0.002	0.021	0.002	0.113	0.910
	4 comorbidities	−0.026	0.024	−0.016	−1.107	0.268
	5 comorbidities	0.008	0.026	0.004	0.309	0.758
	6 or more comorbidities	0.004	0.029	0.003	0.144	0.885

^aVariable dependent: LNCOST.

Data availability statement

Data is available upon request to authors.