Purpose: The influence of medication treatment patterns on resource use for patients hospitalized for schizophrenia was studied.
Methods: Patients hospitalized with a primary diagnosis of schizophrenia or schizo-affective disorder discharged between October 1, 2003, and September 30, 2004, were identified from a large, multihospital database. The duration of dosage adjustment was defined as the period between first and last days of dosage change. Ordinary least-squares regression was used to examine the relationships between labeled dosage-escalation durations, actual durations of dosage adjustment, and length of stay.
Results: The study sample consisted of 21,950 hospitalized schizophrenia patients, representing 30,873 hospitalizations from 157 hospitals. The majority of patients were 18-44 years old (56.3%), covered by Medicare (46.6%), and admitted through the emergency room (55.5%). The average length of hospital stay was 10 days, and 30% of patients were readmitted for a related reason within 90 days. The labeled dosage-escalation duration was not correlated with the actual duration of dosage adjustment (r = 0.05, p < 0.0001) or with longer hospital stays (r = -0.03, p < 0.0001). Drug-related factors affecting length of stay included medication changes (p < 0.0001), dose changes (p < 0.0001), use of short-acting intramuscular antipsychotics ( p < 0.0001), and medications to manage extrapyramidal symptoms (p < 0.0001).
Conclusion: Analysis of information about patients hospitalized for schizophrenia revealed that antipsychotic medication changes, prolonged dosage escalation, and initial use of short-acting intramuscular antipsychotics were significantly associated with a greater than average length of stay. Longer labeled dosage-escalation durations were not associated with longer hospital stays.