Background: Large scale descriptive epidemiological studies describing the demographic and clinical characteristics, comorbidities and quality indicators of Medicare-Medicaid dually eligible persons with schizoaffective disorder are lacking.
Objectives: Among dually eligible Medicare and Medicaid enrollees (MMEs), we sought to: 1) characterize patients with schizoaffective disorder with respect to sociodemographics and physical/mental comorbid conditions; 2) describe health care utilization; and 3) explore quality measures
Methods: Using the Medicare 5% Limited Dataset Files, ICD-9 codes and medical claims, we identified 4,902 MME eligible adults with ≥1 inpatient or ≥2 outpatient claims in 2012 with a diagnosis of schizoaffective disorder (ICD-9CM 295.7). Comorbid conditions, associated health care utilization and quality measure attainment were captured. Resource utilization was quantified per 1000 patients.
Results: 50.7% were women and over half (51.2%) were 45 - 65 years old The five most common chronic physical conditions included diabetes (35.6%), asthma/COPD (31.7%), arthritis (19.3%), heart disease (18.3%), and stroke (8.2%). Psychiatric comorbidity was prevalent with 56.9% with diagnosed depression, 32.9% bipolar disorder, 32.9% personality disorder, 17.4% psychosis, and 12.0% substance abuse disorders. All-cause hospital admissions and emergency room visits were (129/1000 patients and 262/1000 patients, respectively). 17.3% of study patients were rehospitalized within 30 days post-discharge, 18.7% received follow-up care within 7 days, and 42.7% within 30 days post discharge.
Conclusions: MME schizoaffective patients have multiple physical and mental comorbid conditions which may impact health care utilization patterns. The extent to which improvements in quality and follow-up care can reduce readmissions needs to be explored.