S252. HEALTH CARE RESOURCE UTILISATION IS HIGHER IN PATIENTS PRIOR TO DIAGNOSIS WITH SCHIZOPHRENIA THAN NON-SCHIZOPHRENIA COMPARATORS IN A LARGE COMMERCIALLY-INSURED POPULATION IN THE UNITED STATES
Notice bibliographique
Résumé
Schizophrenia is associated with considerable health care resource utilisation (HCRU) and costs, yet little is known about the patterns of care and HRCU in patients with schizophrenia prior to diagnosis. To address this knowledge gap, we examined the HCRU of patients with and without schizophrenia over a 5-year pre-diagnosis period. This US-based retrospective study used claims data from the HealthCore Integrated Research Database to identify newly diagnosed patients with schizophrenia (ICD-9: 295.x, ICD-10: F20.x) aged 15–54 years at diagnosis. Patients with schizophrenia were compared with a demographically matched (1:4) non-schizophrenia cohort during the 0–12 months, >1–2, >2–3, >3–4 and >4–5 years prior to schizophrenia diagnosis. During the pre-diagnosis periods, both all-cause and behavioural health-related HCRU were described. The schizophrenia and comparator cohorts included 6,732 and 26,928 patients, respectively. The most common types of schizophrenia were schizoaffective disorder (49%), paranoid (24%) and unspecified (19%). Patients were distributed across all major US regions (Northeast: 18%, Midwest: 27%, South: 29%, West: 27%). Average age at diagnosis was 32.8 years and most patients were male (57.4%). The percentage of patients with at least one all-cause inpatient hospitalisation in the 0–12 months prior to diagnosis was 32.7% for patients with schizophrenia versus 3.9% for comparators. Patients with schizophrenia had a greater mean number of all-cause physician office visits in all pr- diagnosis time periods versus comparators (schizophrenia: 4.5–5.5 visits, comparators: 3.1–3.2 visits). Behavioural health-related HCRU was also more substantial in patients with schizophrenia versus comparators across all time periods in terms of the mean number of visits to a psychiatrist (1.8–2.9 vs 0.1 visits, respectively) or a psychologist (1.0–1.2 vs 0.2 visits, respectively). The percentage of patients with claims for antipsychotic medication was also greater in the schizophrenia cohort vs comparators (21.8–56.6% vs 0.7–1.0% of patients, respectively). For up to 5 years prior to diagnosis, patients with schizophrenia have higher all-cause and behavioural health-related HCRU, in addition to higher use of anti-psychotic medications, compared with matched comparators. In the schizophrenia cohort, HCRU increased in frequency closer to diagnosis, compared with matched comparators, whose HCRU remained relatively stable. This study improves our understanding of the characteristics of clinically high-risk patients who go on to develop schizophrenia, who have more frequent encounters with health care providers than comparators. These results also suggest that early identification and treatment of patients prior to schizophrenia diagnosis could be optimised and is warranted. Funding: Boehringer Ingelheim (ANTHEM)
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Comment cette classification a été obtenuedéplier
Prédiction machine sur la base complète
Imitation des enseignantsNi prévalence calibrée, ni vérité terrain. Validation humaine à venir. Le volet Gemma est une étiquette directe du modèle pour chaque travail de la base, lue sur la notice réduite au titre. Le volet Codex est un classifieur appris des 10 348 étiquettes directes de Codex et calibré sur les taux pondérés de l'échantillon; les champs sans appui suffisant ne portent aucun appel Codex. Le mode candidate est l'union des deux volets; le consensus est leur intersection. Ces sorties portent le statut machine_predicted_unvalidated et ne sont pas des étiquettes humaines.
Scores du classifieur distillé par catégorie (deux têtes)
| Catégorie | Codex | Gemma |
|---|---|---|
| Métarecherche | 0,000 | 0,002 |
| Méta-épidémiologie (sens strict) | 0,000 | 0,000 |
| Méta-épidémiologie (sens large) | 0,000 | 0,001 |
| Bibliométrie | 0,001 | 0,002 |
| Études des sciences et des technologies | 0,000 | 0,000 |
| Communication savante | 0,001 | 0,000 |
| Science ouverte | 0,000 | 0,000 |
| Intégrité de la recherche | 0,000 | 0,000 |
| Charge utile insuffisante (le modèle a refusé de juger) | 0,008 | 0,001 |
Scores machine (provisoires)
Les deux têtes enseignantes du modèle étudiant, lues sur ce travail. Un score ordonne la base pour la relecture; il n'affirme jamais une catégorie, et le statut de validation accompagne chaque rangée tel quel.
Scores de référence d'un modèle non mature (critères de maturité non atteints, 7 itérations). Un score ordonne; il n'affirme jamais une catégorie.
score_only:v0-immature-baseline · tel quel depuis la passe de notation : score_only signifie que le nombre peut ordonner les travaux, et qu'aucune étiquette de catégorie n'en découleClassification
machine, non validéePrédiction automatique; un appel candidat d’une seule source (Gemma direct ou Codex distillé), pas un consensus.
Le détail, modèle par modèle et score par score, se trouve en fin de page sous « Comment cette classification a été obtenue ».