Assessment of the Impact of Schizophrenia on Healthcare Resource Use Among Patients with Cardiometabolic Conditions in England: Insights from Big Data Analysis

Abstract

Objectives Having schizophrenia increases the risk of developing cardiometabolic conditions, increasing costs and complicating management. This retrospective cohort study among patients with cardiometabolic conditions in England aimed to determine the impact of comorbid schizophrenia on primary and secondary healthcare use, and on the costs of nonelective inpatient admissions, as well as whether this burden is influenced by the number of a patient’s cardiometabolic conditions. Methods Primary and secondary healthcare use data were collected from the Clinical Practice Research Datalink and Hospital Episode Statistics databases, respectively. Adults with ≥1 cardiometabolic condition(s) were grouped according to the conditions, and whether they had schizophrenia. Healthcare resource use, and costs of nonelective admissions were calculated for patient with/without schizophrenia and any, 1, 2, 3, or 4 cardiometabolic condition(s). Results were adjusted for age and sex. Abstract Results Patients with comorbid schizophrenia had 68% more GP appointments (18.09 versus 11.07 appointments/patient/ year), 19% more prescriptions (4.20 versus 5.06 prescriptions/ patient/year), 21% more outpatient appointments (7.94 versus 6.60 appointments/patient/year), 189% more A&E attendances (2.31 versus 0.80 attendances/patient/year), and 127% more nonelective inpatient admissions (1.69 versus 0.77 admissions/patient/year) than those without. The higher number of nonelective admissions represented £1,420.36 increased spending/patient/year, translating into a potential spend of more than £31M annually. Schizophrenia was associated with higher secondary care resource use after adjusting for the number of cardiometabolic conditions. Conclusions Among patients with cardiometabolic conditions, comorbid schizophrenia is associated with higher primary and secondary healthcare resource use and cost, even after adjusting for the number of cardiometabolic conditions.