Healthcare spending among community-dwelling adults with schizophrenia

BACKGROUND: Although expenditures for schizophrenia have been documented previously, direct medical expenses have not been updated to reflect the most recent national data available. OBJECTIVE: To identify current direct medical expenditures for schizophrenia and comorbidities among community-dwelling adults in the United States. STUDY DESIGN: Cross-sectional. METHODS: Nationally representative data from the 2001 and 2002 Medical Expenditure Panel Surveys were analyzed to identify community-dwelling adults, aged 20 years, who incurred expenses for selected comorbidities. Annual direct medical spending estimates by site of service and payer source were produced using the average of these 2-year data. Mean and median per-person comorbidity costs among patients with schizophrenia expenses were determined for the following conditions: diabetes, hypertension, heart disease, and dyslipidemia. RESULTS: Five hundred seventy-one thousand community-dwelling adults incurred USD 2.13 billion per year in direct medical expenses for schizophrenia in 2001-2002; mean and median yearly per-patient expenses were USD 3726 and USD 1748, respectively. Inpatient care accounted for 13% of expenditures, while ambulatory care and prescription drugs accounted for 75%. Medicaid incurred USD 1 billion spent on schizophrenia treatment. Mean per-person spending for schizophrenia patients with comorbidities ranged from USD 3913 per year for those with comorbid hypertension to USD 5618 per year for those with comorbid dyslipidemia. Mean annual total healthcare expenditures for patients with schizophrenia ranged from USD 5990 for those with no comorbid conditions to USD 12 292 for those with comorbid hypertension. CONCLUSION: The majority of schizophrenia expenses incurred by patients living in the community occur in an outpatient setting and not in the hospital. Medicaid is the primary payer source for this condition. Among adults with schizophrenia, the costs of comorbidities vary by condition, but are associated with increased expenditures.