Browse > Article
http://dx.doi.org/10.22722/KJPM.2018.26.1.26

Chronic Physical Comorbidities and Total Medical Costs in Patients with Schizophrenia  

Lee, Sang-Uk (National Center for Mental Health)
Lee, Ye-rin (Department of Preventive Medicine, School of Medicine, Kyung Hee University)
Oh, In-Hwan (Department of Preventive Medicine, School of Medicine, Kyung Hee University)
Ryu, Vin (National Center for Mental Health)
Goo, Ae-Jin (National Center for Mental Health)
Kim, You-Seok (National Center for Mental Health)
Publication Information
Korean Journal of Psychosomatic Medicine / v.26, no.1, 2018 , pp. 26-34 More about this Journal
Abstract
Objectives : This study tried to explore the prevalence of chronic physical diseases in patients with schizophrenia and its effects on total medical costs. Methods : The Health Insurance Review and Assessment Service data in 2014-2015 was employed. Only the injuries and diseases, identically diagnosed 3 times or more as a major or minor injury and disease, were classified into chronic physical diseases to improve data accuracy. Total medical costs included out-of-pocket and insurer's costs from health care system perspective. Results : It was shown that 24.5%, 17.3% and 23.4% of schizophrenia patients had one, two and three or more chronic physical diseases, respectively. There was a high prevalence of not only metabolic, but also musculoskeletal, diseases in those patients. The amount of 2015 total medical costs of patients with schizophrenia in 2014 was about 1.08 trillion won. The factors affecting the costs included sex, age, number of chronic physical diseases, and health insurance status. Conclusions : It is considered that clinical practice guidelines based on personal diseases may not sufficiently solve the problems for comorbidities in schizophrenia patients. Accordingly, it should be required to develop models for new types of medical systems capable of treating and caring varied illnesses at the same time.
Keywords
Schizophrenia; Comorbidities; Chronic physical comorbidities; Medical cost;
Citations & Related Records
Times Cited By KSCI : 3  (Citation Analysis)
연도 인용수 순위
1 World Health Organization. Prevention of Mental Disorders: Effective Interventions and Policy Options. Geneva: World Health Organization 2004;15-16.
2 Bloom D, Cafiero E, Jane-Llopis E, Abrahams-Gessel S, Bloom L, Fathima S, Feigl A, Gaziano T, Hamandi A, Mowaf M, O'Farrell D, Ozaltin E, Pandya A, Prettner K, Rosenberg L, Seligman B, Stein A, Weinstein C, Weiss J. The global economic burden of noncommunicable diseases. Geneva: World Economic Forum 2012.
3 Korea Health Industry Development Industry. Mental illness sector R & D trends and implications (HT R&D No 2013- 006). Osong;2013.
4 Chang SM, Cho SJ, Jeon HJ, Hahm BJ, Lee HJ, Park JI, Cho MJ. Economic burden of schizophrenia in South Korea. J Korean Med Sci 2008;23:167-75.   DOI
5 Ministry of Health & Welfare. The epidemiological survey of mental disorders in Korea. Sejong;2016.
6 McGrath J, Saha S, Chant D, Welham J. Schizophrenia: a concise overview of incidence, prevalence, and mortality. Epidemiol Rev 2008;30:67-76.   DOI
7 Goff DC, Cather C, Evins AE, Henderson DC, Freuden- reich O, Copeland PM, Sacks FM. Medical morbidity and mortality in schizophrenia: guidelines for psychiatrists. J Clin Psychiatry 2005;66:183-194.   DOI
8 HERT M, Correll CU, Bobes J, CETKOVICH-BAKMAS M, Cohen DA, Asai I Detraux J, Gautam S, MOLLER HJ, Ndetei DM. Physical illness in patients with severe mental disorders. I. Prevalence, impact of medications and disparities in health care. World psychiatry 2011;10:52-77.   DOI
9 Mitchell AJ, Vancampfort D, Sweers K, Winkel R, Yu W, De Hert M. Prevalence of metabolic syndrome and metabolic abnormalities in schizophrenia and related disorders-a systematic review and meta-analysis. Schizophr Bull 2011;39: 306-318.
10 Prados-Torres A, Calderon-Larranaga A, Hancco-Saavedra J, Poblador-Plou B, van den Akker M. Multimorbidity patterns: a systematic review. J Clin Epidemiol 2014;67:254-266.   DOI
11 Jun JA, Son SJ, Lee NH, Choi JH. Prevalence of Multimorbidity and Transitional Patterns of Chronic Diseases among Korean Adults. Seoul: Korea Institute for Health and Social Affairs 2014.
12 Aitken D, Buchbinder R, Jones G, Winzenberg T. Interventions to improve adherence to exercise for chronic musculoskeletal pain in adults. Aust Fam Physician 2015:44:39-42.
13 Kim LY, Jin SK, Kim Y, Kim SR, Kim SY, Tchoe BH, Jeong HS, Lee TR. Developing the inpatient sample for the National Health Insurance claims data. Health Policy Manag 2013;23:152-161.   DOI
14 Lee TJ, Kim YH, Shin SJ, Song HJ, Park JY, Jung YJ. Costing method in Healthcare. National Evidence-based Healthcare Collaborating Agency 2012:1-312.
15 Carney CP, Jones L, Woolson RF. Medical comorbidity in women and men with schizophrenia: a population-based controlled study. J Gen Intern Med 2006;21:1133-1137.   DOI
16 Kang KD, Sea YH, Yoon BH. Prevalence of metabolic syndrome in chronic schizophrenic inpatients. J Korean Soc Biol Psychiatry 2012;18:281-289.
17 Brown S, Birtwistle J, Roe L, Thompson C. The unhealthy lifestyle of people with schizophrenia. Psychol Med 1999;29: 697-701.   DOI
18 Starfeld B. Challenges to primary care from co-and multimorbidity. Prim Health Care Res Dev 2011;12:1.
19 Crump C, Winkleby MA., Sundquist K, Sundquist J. Comorbidities and mortality in persons with schizophrenia: a Swedish national cohort study. Am J Psychiatry 2013;170:324-333.   DOI
20 Kwon YH, Kwag OG. Effects of Group Tai Chi Exercise Prograam on Body Mass Index (BMI), Positive and Negative Psychiatric Symptoms in Patient with Schizophrenia. Korean J Rehabil Nurs 2011;14:129-135.
21 Lee SU. Risk factors for Relapse and Physical illness in Patients with First-Episode Schizophrenia. Seoul: Graduate School of Kyung Hee University 2017.
22 Bostman OM. Body mass index and height in patients requiring surgery for lumbar intervertebral disc herniation. Spine 1993;18:851-854.   DOI
23 Marder SR, Essock SM, Miller AL, Buchanan RW, Casey DE, Davis JM, Stroup S. Physical health monitoring of patients with schizophrenia. Am J Psychiatry 2004;161:1334- 1349.   DOI
24 Picot MC, Baldy-Moulinier M, Daures JP, Dujols P, Crespel A. The prevalence of epilepsy and pharmacoresistant epilepsy in adults: A population-based study in a Western European country. Epilepsia 2008;49:1230-1238.   DOI
25 Lee AR, Kim SL. Prevalence and Risk Factors of Knee Pain in Korean Adults: Results from Korea National Health and Nutrition Examination Survey, 2010-2012. J Health Info Stat 2015;40:129-139.
26 Jung YH, Ko SJ, Kim EJ. A study on the effective chronic disease management. Seoul: Korea Institute for Health and Social Affairs 2013.
27 Piette JD, Kerr EA. The impact of comorbid chronic conditions on diabetes care. Diabetes Care 2006;29:725-731.   DOI
28 Kim MH. Epidemiology of Rheumatoid Arthritis Patients. J Korean Med Assoc 1986;29:1-7.
29 Lieberman JA, Stroup TS, McEvoy JP. Effectiveness of antipsychotic drugs in patients with chronic schizophrenia. N Engl j Med 2005;353:1209-1223.   DOI
30 Ford ES, Giles WH, Dietz WH. Prevalence of the metabolic syndrome among US adults: fndings from the third National Health and Nutrition Examination Survey. Jama 2002;287: 356-359.   DOI
31 Harman JS, Edlund MJ, Fortney JC, Kallas H. The infuence of comorbid chronic medical conditions on the adequacy of depression care for older Americans. J Am Geriatr Soc 2005;53:2178-2183.   DOI
32 Yoon J, Zulman D, Scott JY, Maciejewski ML. Costs associated with multimorbidity among VA patients. Med Care 2014; 52:S31-S36.   DOI
33 Kim CH, Lee MR, Yoo WS. Common combinations of chronic diseases in multimorbidity and their effect on healthcare cost in Korea. Korean Journal of Health Economics and Policy 2014;20:81-102.
34 Heo DS. The fantasy of a new healthcare policy in Korea. J Korean Med Assoc 2017;60:936-939.   DOI
35 Cha SK, Kim SS. The determinant of the length of stay in hospital for schizophrenic patients: using data from the indepth injury patient surveillance system. J Digit Converg 2013; 11:351-359.   DOI
36 Shin YS. On the Appropriate Use of Health Services. Health and Welfare Policy Forum 2006;114:91-101.