Schizophrenia hospitalization in the US 2005-2014: Examination of trends in demographics, length of stay, and cost.
Schizophrenia hospitalization in the US 2005-2014: Examination of trends in demographics, length of stay, and cost.
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DOI：
10.1097/md.0000000000025206
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发表时间：
2021-04-16
期刊：
影响因子：
1.6
通讯作者：
Banta JE
中科院分区：
文献类型：
--
作者：
Chen E;Bazargan-Hejazi S;Ani C;Hindman D;Pan D;Ebrahim G;Shirazi A;Banta JE
首先，我们的目的是检查2005年至2014年精神分裂症住院的粗标准化趋势。我们假设，从2005年到2014年，精神分裂症的住院率将呈现统计学显著的线性趋势。其次，我们还研究了按种族/民族、年龄、性别划分的住院趋势，以及住院时间（LOS）和通货膨胀调整后费用的趋势。在这项观察性研究中，我们使用了全国住院患者样本数据和国际疾病分类第十一次修订版精神分裂症代码，该研究显示了6，122，284例病例。结果包括粗和标准化住院率、种族/民族、年龄、费用和LOS。分析包括描述性统计、间接标准化、Rao-Scott卡方检验、t检验和校正线性回归趋势。45-64岁的人住院最普遍（38.8%），非裔美国人占多数（占住院人数的25.8%），性别分布几乎相等。平均LOS为9.08天（95%置信区间8.71-9.45）。 医疗保险是大多数住院的主要支付者（55.4%），大多数费用在10，000美元至49，999美元之间（57.1%）。粗住院率范围为790-1142/100，000入院，而美国2010年人口普查标准化率为380-552/100，000。线性回归趋势分析显示，种族/民族、年龄或性别的趋势没有显着差异（P>.001）。 住院总率增加，而LOS显著下降，而住院费用和Charlson共病指数增加（P <0.001）。 从2005年到2014年，美国整体住院率显著上升。在此期间，观察到的中年和非洲裔美国人住院的差异没有变化，LOS下降，而费用上升。需要进一步研究解决种族/民族和年龄的重要差异，并降低急性住院费用。
Primarily we aimed to examine the crude and standardized schizophrenia hospitalization trend from 2005 to 2014. We hypothesized that there will be a statistically significant linear trend in hospitalization rates for schizophrenia from 2005 to 2014. Secondarily we also examined trends in hospitalization by race/ethnicity, age, gender, as well as trends in hospitalization Length of Stay (LOS) and inflation adjusted cost. In this observational study, we used Nationwide Inpatient Sample data and International Classification of Diseases, Eleventh Revisions codes for Schizophrenia, which revealed 6,122,284 cases for this study. Outcomes included crude and standardized hospitalization rates, race/ethnicity, age, cost, and LOS. The analysis included descriptive statistics, indirect standardization, Rao-Scott Chi-Square test, t-test, and adjusted linear regression trend. Hospitalizations were most prevalent for individuals ages 45–64 (38.8%), African Americans were overrepresented (25.8% of hospitalizations), and the gender distribution was nearly equivalent. Mean LOS was 9.08 days (95% confidence interval 8.71–9.45). Medicare was the primary payer for most hospitalizations (55.4%), with most of the costs ranging from $10,000-$49,999 (57.1%). The crude hospitalization rates ranged from 790–1142/100,000 admissions, while the US 2010 census standardized rates were 380–552/100,000 from 2005–2014. Linear regression trend analysis showed no significant difference in trend for race/ethnicity, age, nor gender (P > .001). The hospitalizations’ overall rates increased while LOS significantly decreased, while hospitalization costs and Charlson's co-morbidity index increased (P < .001). From 2005–2014, the overall US hospitalization rates significantly increased. Over this period, observed disparities in hospitalizations for middle-aged and African Americans were unchanged, and LOS has gone down while costs have gone up. Further studies addressing the important disparities in race/ethnicity and age and reducing costs of acute hospitalization are needed.