Medical Care, Medical Costs and Medication Adherence of Schizophrenics with Metabolic Disorder

In Taiwan, the prevalence of metabolic disorders (type II diabetes mellitus, hypertension. Hyperlipidemia) among individuals with schizophrenia are higher than those of general population. In addition, schizophrenics, compared with individuals without schizophrenia, have a higher risk of developing metabolic disorders. Therefore, whether schizophrenia affects metabolic disorders’ access to medical care, emergency room visits or hospital admission, and medical care utilization and costs is a public issue of importance. This study aims to evaluate the impact of schizophrenia on metabolic disorder-related care, disease-related emergency room visits or hospital admission, and utilization and costs of health care through comparing prevalent cases in 2005 and observing incident cases in 2005 for four years. This study will use the National Health Insurance Research Database (NHIRD) to select eligible subjects (prevalent and incidence cases). Individuals with schizophrenia and comorbid metabolic disorder will be selected (the case group), and individuals with the metabolic disorder and without schizophrenia will be selected by 1:1 matching with the case group by age and gender. This study will compare their disease-related annual exams, enrollment in the pay-for performance (diabetes and hypertension only), medication use patterns (anti-diabetic drugs, antihypertensive drugs, and lipid-lowering drugs) and medication adherence, diabetes-related emergency room visit or hospital admission, and utilization and costs of health care. The findings of this study will be of importance to provide information regarding whether the care for metabolic disorders of individuals with schizophrenia is compromised because of their mental disease, and if so, how to design the intervention to improve the quality of metabolic disorder care for individuals with schizophrenia.

Project ID:PF10107-1878
External Project ID:NSC101-2410-H182-026