Abstract

Objective: This study explores the association between psychiatrist case volumes and costs for hospitalized schizophrenia patients. Methods: The study uses the Taiwan National Health Insurance Research Database for 2003, identifying the study subjects from the database by ICD-9-CM principal diagnosis code 295. Our study sample comprises of 135,621 admissions treated by 787 psychiatrists in 181 hospitals, with the sample being divided equally into three psychiatrist volume groups: ≤ 300 (low volume), 301-600 (medium volume) and ≥ 601 admissions (high volume). After adjusting for psychiatrist, patient and hospital characteristics, multiple regression analyses were performed to determine the association between psychiatrist case volume and hospitalization costs (total, drug, and non-drug). Results: The regression analyses showed that after adjusting for psychiatrist, patient and hospital characteristics, average treatment costs associated with hospitalized schizophrenia patients were inversely related to psychiatrist volume. The respective total costs, drug costs and non-drug costs of patients treated by high-volume psychiatrists were US$369 (p <0.001), US$26 (p <0.001) and US$343 (p <0.001) lower than those of low-volume psychiatrists. The respective total costs, drug costs and non-drug costs for those treated by medium-volume psychiatrists were US$248 (p <0.001), US$22 (p <0.001) and US$226 (p <0.001) lower than those of low-volume psychiatrists. Conclusions: We find that after adjusting for patient, psychiatrist and hospital characteristics, an inverse volume-cost relationship exists for psychiatrists treating schizophrenia patients. Further studies should aim to investigate the volume-quality relationship to ensure that incremental cost savings associated with increased patient volume are not achieved at the expense of quality of patient care.

Original languageEnglish
Pages (from-to)283-290
Number of pages8
JournalSchizophrenia Research
Volume81
Issue number2-3
DOIs
Publication statusPublished - Jan 31 2006

Fingerprint

Psychiatry
Schizophrenia
Hospitalization
Costs and Cost Analysis
Population
Drug Costs
Regression Analysis
Databases
Cost Savings
Quality of Health Care
National Health Programs
International Classification of Diseases
Taiwan
Health Care Costs
Patient Care

Keywords

  • Inpatient psychiatry
  • Outcome studies
  • Schizophrenia

ASJC Scopus subject areas

  • Psychiatry and Mental health
  • Behavioral Neuroscience
  • Biological Psychiatry
  • Neurology
  • Psychology(all)

Cite this

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title = "The association between psychiatrist numbers and hospitalization costs for schizophrenia patients: A population-based study",
abstract = "Objective: This study explores the association between psychiatrist case volumes and costs for hospitalized schizophrenia patients. Methods: The study uses the Taiwan National Health Insurance Research Database for 2003, identifying the study subjects from the database by ICD-9-CM principal diagnosis code 295. Our study sample comprises of 135,621 admissions treated by 787 psychiatrists in 181 hospitals, with the sample being divided equally into three psychiatrist volume groups: ≤ 300 (low volume), 301-600 (medium volume) and ≥ 601 admissions (high volume). After adjusting for psychiatrist, patient and hospital characteristics, multiple regression analyses were performed to determine the association between psychiatrist case volume and hospitalization costs (total, drug, and non-drug). Results: The regression analyses showed that after adjusting for psychiatrist, patient and hospital characteristics, average treatment costs associated with hospitalized schizophrenia patients were inversely related to psychiatrist volume. The respective total costs, drug costs and non-drug costs of patients treated by high-volume psychiatrists were US$369 (p <0.001), US$26 (p <0.001) and US$343 (p <0.001) lower than those of low-volume psychiatrists. The respective total costs, drug costs and non-drug costs for those treated by medium-volume psychiatrists were US$248 (p <0.001), US$22 (p <0.001) and US$226 (p <0.001) lower than those of low-volume psychiatrists. Conclusions: We find that after adjusting for patient, psychiatrist and hospital characteristics, an inverse volume-cost relationship exists for psychiatrists treating schizophrenia patients. Further studies should aim to investigate the volume-quality relationship to ensure that incremental cost savings associated with increased patient volume are not achieved at the expense of quality of patient care.",
keywords = "Inpatient psychiatry, Outcome studies, Schizophrenia",
author = "Lee, {Hsin Chien} and Tsai, {Shang Ying} and Lin, {Herng Ching} and Chen, {Chu Chieh}",
year = "2006",
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doi = "10.1016/j.schres.2005.10.007",
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T1 - The association between psychiatrist numbers and hospitalization costs for schizophrenia patients

T2 - A population-based study

AU - Lee, Hsin Chien

AU - Tsai, Shang Ying

AU - Lin, Herng Ching

AU - Chen, Chu Chieh

PY - 2006/1/31

Y1 - 2006/1/31

N2 - Objective: This study explores the association between psychiatrist case volumes and costs for hospitalized schizophrenia patients. Methods: The study uses the Taiwan National Health Insurance Research Database for 2003, identifying the study subjects from the database by ICD-9-CM principal diagnosis code 295. Our study sample comprises of 135,621 admissions treated by 787 psychiatrists in 181 hospitals, with the sample being divided equally into three psychiatrist volume groups: ≤ 300 (low volume), 301-600 (medium volume) and ≥ 601 admissions (high volume). After adjusting for psychiatrist, patient and hospital characteristics, multiple regression analyses were performed to determine the association between psychiatrist case volume and hospitalization costs (total, drug, and non-drug). Results: The regression analyses showed that after adjusting for psychiatrist, patient and hospital characteristics, average treatment costs associated with hospitalized schizophrenia patients were inversely related to psychiatrist volume. The respective total costs, drug costs and non-drug costs of patients treated by high-volume psychiatrists were US$369 (p <0.001), US$26 (p <0.001) and US$343 (p <0.001) lower than those of low-volume psychiatrists. The respective total costs, drug costs and non-drug costs for those treated by medium-volume psychiatrists were US$248 (p <0.001), US$22 (p <0.001) and US$226 (p <0.001) lower than those of low-volume psychiatrists. Conclusions: We find that after adjusting for patient, psychiatrist and hospital characteristics, an inverse volume-cost relationship exists for psychiatrists treating schizophrenia patients. Further studies should aim to investigate the volume-quality relationship to ensure that incremental cost savings associated with increased patient volume are not achieved at the expense of quality of patient care.

AB - Objective: This study explores the association between psychiatrist case volumes and costs for hospitalized schizophrenia patients. Methods: The study uses the Taiwan National Health Insurance Research Database for 2003, identifying the study subjects from the database by ICD-9-CM principal diagnosis code 295. Our study sample comprises of 135,621 admissions treated by 787 psychiatrists in 181 hospitals, with the sample being divided equally into three psychiatrist volume groups: ≤ 300 (low volume), 301-600 (medium volume) and ≥ 601 admissions (high volume). After adjusting for psychiatrist, patient and hospital characteristics, multiple regression analyses were performed to determine the association between psychiatrist case volume and hospitalization costs (total, drug, and non-drug). Results: The regression analyses showed that after adjusting for psychiatrist, patient and hospital characteristics, average treatment costs associated with hospitalized schizophrenia patients were inversely related to psychiatrist volume. The respective total costs, drug costs and non-drug costs of patients treated by high-volume psychiatrists were US$369 (p <0.001), US$26 (p <0.001) and US$343 (p <0.001) lower than those of low-volume psychiatrists. The respective total costs, drug costs and non-drug costs for those treated by medium-volume psychiatrists were US$248 (p <0.001), US$22 (p <0.001) and US$226 (p <0.001) lower than those of low-volume psychiatrists. Conclusions: We find that after adjusting for patient, psychiatrist and hospital characteristics, an inverse volume-cost relationship exists for psychiatrists treating schizophrenia patients. Further studies should aim to investigate the volume-quality relationship to ensure that incremental cost savings associated with increased patient volume are not achieved at the expense of quality of patient care.

KW - Inpatient psychiatry

KW - Outcome studies

KW - Schizophrenia

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JF - Schizophrenia Research

SN - 0920-9964

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