ECONOMIC IMPACT OF TARDIVE DYSKINESIA AMONG HOSPITALIZED SCHIZOPHRENIA PATIENTS: EVIDENCE FROM US ADMINISTRATIVE DATA
Author(s)
Natalie S. Laster, BS-C1, Douglas L. Leslie, PhD2, Christopher Hollenbeak, PhD3;
1The Pennylvania State University, University Park, PA, USA, 2Penn State College of Medicine, Hershey, PA, USA, 3The Pennsylvania State University, Professor and Department Head, Hummelstown, PA, USA
1The Pennylvania State University, University Park, PA, USA, 2Penn State College of Medicine, Hershey, PA, USA, 3The Pennsylvania State University, Professor and Department Head, Hummelstown, PA, USA
OBJECTIVES: Tardive dyskinesia (TD) is a neurological side effect of long-term exposure to antipsychotic medications characterized by involuntary movements of the face and limbs. TD can be both physically and emotionally distressing for patients and has been associated with poorer quality of life. The objective of this study was to estimate the incremental impact of TD on the length of hospital stay, and total inpatient cost of care of patients hospitalized for schizophrenia.
METHODS: A cohort of patients hospitalized with schizophrenia between 2012 and 2021 were identified in the National Inpatient Sample (NIS). Outcomes included hospital length of stay (LOS) and total inpatient costs, adjusted for inflation to 2023 U.S. dollars. Generalized linear models were used to model the relationship between TD, LOS, and costs; propensity score matching was used to control for potential covariate imbalance.
RESULTS: Among 450,870 patients with a primary diagnosis of schizophrenia admitted to a US hospital between 2012 and 2021, 3,226 (0.72%) had a TD diagnosis. Patients with TD tended to be older, female, covered by Medicare, and have more comorbidities. After controlling for covariates, a TD diagnosis was associated with a longer LOS of 4.5 days (P<0.0001) and greater costs of $4,874.06 (P=<0.0001). These were largely confirmed by the propensity score analysis, which adequately matched all 3,226 patients with TD to a similar patient without TD. After matching, patients with TD had a significantly longer LOS (17.6 days vs. 11.5 days, p<0.0001) and significantly higher costs ($18,487 vs. $12,361, p<0.0001) than matched patients without TD.
CONCLUSIONS: A diagnosis of TD is associated with significantly poorer economic outcomes among patients hospitalized for schizophrenia. These results underscore TD not only as a burdensome neurological side effect of antipsychotic treatment but also as a potential driver of healthcare resource utilization in this vulnerable population.
METHODS: A cohort of patients hospitalized with schizophrenia between 2012 and 2021 were identified in the National Inpatient Sample (NIS). Outcomes included hospital length of stay (LOS) and total inpatient costs, adjusted for inflation to 2023 U.S. dollars. Generalized linear models were used to model the relationship between TD, LOS, and costs; propensity score matching was used to control for potential covariate imbalance.
RESULTS: Among 450,870 patients with a primary diagnosis of schizophrenia admitted to a US hospital between 2012 and 2021, 3,226 (0.72%) had a TD diagnosis. Patients with TD tended to be older, female, covered by Medicare, and have more comorbidities. After controlling for covariates, a TD diagnosis was associated with a longer LOS of 4.5 days (P<0.0001) and greater costs of $4,874.06 (P=<0.0001). These were largely confirmed by the propensity score analysis, which adequately matched all 3,226 patients with TD to a similar patient without TD. After matching, patients with TD had a significantly longer LOS (17.6 days vs. 11.5 days, p<0.0001) and significantly higher costs ($18,487 vs. $12,361, p<0.0001) than matched patients without TD.
CONCLUSIONS: A diagnosis of TD is associated with significantly poorer economic outcomes among patients hospitalized for schizophrenia. These results underscore TD not only as a burdensome neurological side effect of antipsychotic treatment but also as a potential driver of healthcare resource utilization in this vulnerable population.
Conference/Value in Health Info
2026-05, ISPOR 2026, Philadelphia, PA, USA
Value in Health, Volume 29, Issue S6
Code
EE340
Topic
Economic Evaluation
Topic Subcategory
Cost/Cost of Illness/Resource Use Studies
Disease
SDC: Neurological Disorders