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Psych Congress  

Health Care Utilization and Quality of Care among Dually Eligible Patients with Schizoaffective Disorder

Authors  
Janice Lopez, PharmD, MPH
Brian Quilliam, PhD
Carmela Benson, MS
Darlene O'Connor, PhD
Kate Lapane, PhD
Daniel Gilden, MS
Sponsor  
Janssen Scientific Affairs, LLC

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.

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