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Abstract
ObjectivesTo understand the region-wise differences in demographics, comorbid substance abuse, and hospital outcomes in adult schizophrenia inpatients with cannabis abuse and medication non-compliance.MethodsWe included 51,975 adults (18-65 years) from the Nationwide Inpatient Sample (2012 to 2014) with a primary diagnosis of schizophrenia and comorbid diagnosis of cannabis abuse and medication non-compliance. We used descriptive statistics and linear-by-linear association to evaluate the region-wise differences in demographics and comorbid substance abuse. Analysis of variance was used for continuous variables such as length of stay (LOS) and total charges during hospitalization to measure the differences across the regions.ResultsOur study inpatients were from the United States regions: northeast ([NE] 30.4%), midwest ([MW] 24.3%), south (27.3%), and west (18%). A higher proportion of young adults (age: 18-35 years; overall total: 62.4%) were from the south (65.1%) and the NE (64.3%) regions. The study population comprised majorly of males in all the regions, ranging from 78.6% to 82.2% (overall total: 80.5%). The west region comprised majorly of whites (42.6%), whereas all other regions majorly had blacks, with the highest seen in the MW (63.2%) and south (63%) regions. The most prevalent comorbid substances in the study inpatients were tobacco (46.3%) and alcohol (32.3%). The mean LOS and total charges for the hospitalization were much higher in the NE region (LOS: 15.8 days; total charges: $44,336).ConclusionCannabis abuse and medication non-compliance in schizophrenia patients were prevalent in the NE region of the United States and in the overall regions, and affects young adults, males, and Blacks from low-income families. This is associated with higher hospitalization stay and cost, which indirectly increase the healthcare burden.
Highlights
Schizophrenia is a complex psychiatric illness characterized by a disruption in the thought process, perception, emotional responsiveness, and social interaction
Our study inpatients were from the United States regions: northeast ([NE] 30.4%), midwest ([MW] 24.3%), south (27.3%), and west (18%)
Of the 1.2 million schizophrenia patients registered in the Medical Expenditure Panel Survey from 2010 to 2014, more than 70% of the patients were non-adherent to antipsychotics [6]
Summary
Schizophrenia is a complex psychiatric illness characterized by a disruption in the thought process, perception, emotional responsiveness, and social interaction. The prevalence of schizophrenia is about 1% globally and is 1 of the top 15 leading causes of disability [2,3]. Schizophrenia has a huge impact on healthcare and is an economic burden; as reported in 2013, it was $155.7 billion including 24% of direct medical service cost, 6% of direct non-medical service cost, and 76% of indirect medical service cost [4]. Medication non-compliance is a major concern in schizophrenia management as it leads to significant suffering to the patients as well as their families, with a rising healthcare burden [6]. Of the 1.2 million schizophrenia patients registered in the Medical Expenditure Panel Survey from 2010 to 2014, more than 70% of the patients were non-adherent to antipsychotics [6].
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