OUTPATIENT VISITS FOR SCHIZOPHRENIA IN THE UNITED STATES- A NATIONALLY REPRESENTATIVE ANALYSIS USING NAMCS AND NHAMES DATA

Author(s)

Stensland MD*, Netzer LM Agile Outcomes Research, Inc., Rochester, MN, USA

OBJECTIVES: To characterize the outpatient visits for schizophrenia in the United States in comparison to major depressive disorder (MDD) and general outpatient (GOP) visits. METHODS: The National Ambulatory Care Survey (NAMCS) and National Hospital Ambulatory Medical Care Survey (NHAMCS) data from 2003 to 2010 were pooled and weighted to provide national level estimates. Using ICD-9 codes, visits were classified as schizophrenia (295.xx) or MDD (296.2x-296.3x) visits; all others were classified as GOP visits. Estimation methods accounting for the surveys’ multistage sampling procedures provided percentages or means and their 95% confidence intervals. RESULTS: Of the estimated 8.45 billion outpatient visits in the United States between 2003-2010, approximately 22.3 million (0.3%) and 73.6 million (0.9%) were for schizophrenia and MDD, respectively. Medicare (35.7% [31.2%-40.4%]) and Medicaid (35.2% [31.4%-39.2%]) were most common payers for schizophrenia visits, whereas private insurance was most common for MDD (49.6% [46.3%-53.0%]) and GOP (52.5% [51.1%-53.9%]) visits. During the previous 12-months, there was a higher number of outpatient visits for schizophrenia (11.9 [9.6-14.3]) and MDD (10.9 [9.6-12.1]) than GOP (4.4 [4.3-4.6]). Primary care physician visits accounted for 17.3% [13.4%-22.1%] of schizophrenia, 10.6% [8.2%-13.7%] of MDD, and 46.5% [44.5%-48.5%] of GOP visits. Psychiatrist visits accounted for 79.7% [73.6%-84.7%] of schizophrenia, 89.8% [86.9%-92.1%] of MDD, and 2.0% [1.9%-2.2%] of GOP visits. More medications were prescribed at schizophrenia (3.0 [2.8-3.3]) than MDD (2.5 [2.3-2.6]) or GOP (2.2 [2.1-2.3]) visits. However, medication initiations were less frequent at schizophrenia (16.8% [13.6%-20.6%]) and MDD (19.6% [17.3%-22.1%]) than GOP (36.4% [35.5%-37.4%]) visits. CONCLUSIONS: The NAMCS and NHAMCS data provided a representative characterization of outpatient treatment for schizophrenia across different payers in the United States. Outpatient visits for schizophrenia differed from MDD or GOP visits across multiple characteristics, including payer type, physician specialty, and medication use.

Conference/Value in Health Info

2013-05, ISPOR 2013, New Orleans, LA, USA

Value in Health, Vol. 16, No. 3 (May 2013)

Code

PHS103

Topic

Economic Evaluation

Topic Subcategory

Cost/Cost of Illness/Resource Use Studies

Disease

Mental Health

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