To estimate the national annual cost of rehospitalization for multiple-episode schizophrenia outpatients, and to determine the relative cost burden from loss of medication efficacy and from medication noncompliance, the yearly number of neuroleptic-responsive multiple-episode schizophrenia inpatients in the United States who are discharged back to outpatient treatment was estimated.
The cohort at risk for future relapse and rehospitalization was determined.
The monthly relapse rates are estimated to be 3.5 percent per month for patients on maintenance neuroleptics and 11.0 percent per month for patients who have discontinued their medication.
Postdischarge noncompliance rates in community settings are estimated to be 7.6 percent per month.
Within 2 years after discharge, the aggregate cost of readmission approached $2 billion.
Loss of neuroleptic efficacy accounted for roughly 60 percent of the rehospitalization costs and neuroleptic noncompliance for roughly 40 percent.
The economic burden due to loss of efficacy is relatively higher during the first postdischarge year, whereas the burden from noncompliance is higher in the second year.
Because loss of medication efficacy and medication noncompliance act synergistically on relapse, substantial inpatient cost savings can be realized by linking better pharmacologic treatments of schizophrenia with more effective strategies to manage medication noncompliance.
Mots-clés Pascal : Schizophrénie, Psychose, Chimiothérapie, Psychotrope, Neuroleptique, Efficacité traitement, Observance médicamenteuse, Récidive, Hospitalisation, Analyse coût, Economie santé, Santé mentale, Etats Unis, Amérique du Nord, Amérique, Homme
Mots-clés Pascal anglais : Schizophrenia, Psychosis, Chemotherapy, Psychotropic, Neuroleptic, Treatment efficiency, Drug compliance, Relapse, Hospitalization, Cost analysis, Health economy, Mental health, United States, North America, America, Human
Notice produite par :
Inist-CNRS - Institut de l'Information Scientifique et Technique
Cote : 95-0489602
Code Inist : 002B18H05B. Création : 01/03/1996.