A Study of Total Medical Cost and Hospitalization Risk of Patients with Schizophrenia and Type 1 Diabetes Mellitus

Sang-Uk Lee; You-Seok Kim

doi:10.16946/kjsr.2019.22.1.8

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Lee and Kim: A Study of Total Medical Cost and Hospitalization Risk of Patients with Schizophrenia and Type 1 Diabetes Mellitus

Original Article

Korean Journal of Schizophrenia Research 2019; 22(1): 8-13.

Published online: 25 April 2019

DOI: https://doi.org/10.16946/kjsr.2019.22.1.8

A Study of Total Medical Cost and Hospitalization Risk of Patients with Schizophrenia and Type 1 Diabetes Mellitus

Sang-Uk Lee, PhD^1,², You-Seok Kim, MD, PhD¹

¹National Center for Mental Health, Seoul, Korea.

²Department of Preventive Medicine, School of Medicine, Kyung Hee University, Seoul, Korea.

Address for correspondence: You-Seok Kim, National Center for Mental Health, 127 Yongmasan-ro, Gwangjin-gu, Seoul 04933, Korea. Tel: 02-2204-0104, Fax: 02-2204-0389, kysmd@hanmail.net

Received 3 January 2019 Revised 2 April 2019 Accepted 3 April 2019

Korean Society for Schizophrenia Research

Abstract

Objectives

The aim of this study was to explore the prevalence of type 1 diabetes in patients with schizophrenia and their total medical costs and risk of hospitalization.

Methods

This study used Health Insurance Review and Assessment Service data in Korea. To examine total medical costs and risk of hospitalization, we selected 1,510 subjects with schizophrenia (half with and half without type 1 diabetes) that were 1:1 matched via propensity score matching. In health care system perspective, total medical costs included out-of-pocket and insurer's costs. Logistic regression models were used to examine the risk of hospitalization.

Results

The prevalence of type 1 diabetes in patients with schizophrenia was 3.87 per 1,000 person year. Among patients with schizophrenia, the amount of total average medical costs and hospitalization costs in patients with type 1 diabetes was 1.49 and 1.59 times higher than those in patients without it, respectively. The odds of hospitalization were higher among patients with type 1 diabetes compared with those without it (odds ratio, OR=1.97 ; 95% CI 1.60–2.43).

Conclusion

This study showed that medical costs and risk of hospitalization were higher in schizophrenia patients with type 1 diabetes. Therefore, these individuals may require specific care programs.

Keywords: Schizophrenia, Comorbidities, Type 1 diabetes, Medical cost

Figures and Tables

Fig. 1

Flow chart for selection of study participants.

Table 1

General characteristics of study participants

*: p<0.0001

Table 2

Total medical costs of schizophrenia patients with vs. without type 1 diabetes mellitus

*: p<0.0001

Table 3

Total average hospitalization costs of schizophrenia patients with vs. without type 1 diabetes mellitus

*: p<0.0001

Table 4

Logistic regression models of hospitalization risk in schizophrenia patients with vs. without type 1 diabetes mellitus

*: p<0.05, †: Adjusted for gender, age, geographical location, medical benefits, medical institutions, comorbidity, ‡: After propensity score matching

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