Schizophrenia Spectrum and Psychotic Disorders

Patients With Schizophrenia Utilize More Health Care Resources Following PCI

Jessica Nye, PhD
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Patients with schizophrenia who receive PCI are likely to experience longer hospital stays and higher hospital costs compared with patients without schizophrenia.

Following percutaneous coronary intervention (PCI), patients with schizophrenia utilize more health care resources than patients without schizophrenia. These findings were presented at the Transcatheter Cardiovascular Therapeutics (TCT) Scientific Symposium 2022 held from September 17th through 19th, in Boston, Massachusetts.

Typically, mental health is overlooked among patients hospitalized for cardiovascular-related complications. However, mental health status has the potential to contribute to outcomes and use of health care resources.

In order to evaluate whether mental health status contributes to health care utilization, investigators from Wayne State University and Detroit Medical Center reviewed data from the National Inpatient Sample. Patient outcomes were evaluated following PCI on the basis of whether or not the patient had diagnosed schizophrenia.

The schizophrenia (n=8345) and control (n=1,681,275) cohorts comprised 24.0% and 9.7% Black individuals (P <.05), 25.0% and 9.3% were covered by Medicaid insurance (P <.05), and 46.0% and 30.0% had lower socioeconomic status (P <.05), respectively.

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Typically, behavioral health teams are not involved during inpatient care, which is hypothesized to contribute to an increased burden of resources and adverse patient course.

Patients with schizophrenia experienced a 1.52 day longer hospital stay (P <.05) and a $12,185.41 greater cost of hospitalization (P <.05) compared with control patients.

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Among the subset of patients who had PCI following acute myocardial infarction, schizophrenia was associated with a similar 1.57 day longer hospital stay (P <.05) and $14,736.98 greater health care cost (P <.05) compared with control patients.

Schizophrenia did not associate with increased mortality risk among the entire study group (odds ratio [OR], 1.13; P =.437) or among the subset of patients who had acute myocardial infarction (OR, 1.10; P =.58).

“History of mental health disorders such as schizophrenia is associated with increased resource use after PCI,” the study authors wrote. “Multiple socioeconomic factors play into this association. Involvement of a behavioral health team during the inpatient course for PCI patients with concurrent diagnoses on the schizophrenia spectrum may lessen hospital resource and care team burden while improving patient outcomes.”

This article originally appeared on The Cardiology Advisor

References:

Mishra T, Patel D, Shafi I, et al. Impact of schizophrenia on in-hospital outcomes among patients undergoing percutaneous coronary interventions: a national inpatient sample analysis. Presented at: Transcatheter Cardiovascular Therapeutics Scientific Symposium; September 17-19, 2022; Boston, MA. Abstract #194.