Continuity of Care and Medical Costs of Health Services for Chronic Mental Disorders – The Cases of Schizophrenia, Major Depressive Disorder and Bipolar Disorder

In Taiwan, individuals with catastrophic illnesses of chronic psychoses (including schizophrenia, major depressive disorder, and bipolar disorder, etc.) accounted for 0.90% of National Health Insurance enrollees, but incurred approximately 2.57% of total healthcare expenditures in 2011. Those suffering from schizophrenia and affective disorders (including major depressive disorder and bipolar disorder) require extensive and intensive healthcare services, and therefore were included in the top 20 most expensive disease categories in 2011. As continuity of care is of importance for those with these mental disorders, this study aims to investigate continuity of care for those with schizophrenia, major depressive disorder, or bipolar disorder, identify risk factors associated discontinuity of care, and evaluate the impact of continuity of care on medication adherence, risk of rehospitalization, and healthcare costs. The National Health Insurance Research Database of 2005-2010 will be used. Subjects who were adults, held catastrophic illness cards of schizophrenia, major depressive disorder, or bipolar disorder, and had outpatient visits during 2006-2008 will be selected. Continuity of care will be analyzed by logistic regression models, risk of rehospitalization will be assessed with Cox proportional hazards models, and healthcare costs will be evaluated by generalized estimating equations. The findings of this study will be of help for health care providers taking care of those suffering from schizophrenia, major depressive disorder, or bipolar disorder, and for public health policy makers to design interventions in order to improve the overall quality of care for individuals with the mental disorders.

Project ID:PF10308-0436
External Project ID:MOST103-2410-H182-027