The Use of the Japanese Public Financial Support Has Positive Impact on Persistence with Outpatient Treatments for Schizophrenia: Single-center Retrospective Cohort Study in Japan

• Published in: Patient preference and adherence 2021-01, Vol.15, p.169-175
• Main Authors: Arikawa, Masatoshi, Ota, Kazumi, Azekawa, Takaharu, Ohashi, Shizuko, Funaoka, Yoichi, Yoshiie, Hiroshi, Koshi, Haruka, Takaishi, Yohei, Nakao, Saeka
• Format: Article
• Language: English
• Subjects: Age; Ambulatory medical care; Cohort analysis; Data collection; Drug therapy; Economic aspects; Federal aid to community health services; financial support; Health aspects; Health insurance; Hospitalization; jiritsu-shien-iryo-hi; Nursing care; Original Research; Patient compliance; Patient outcomes; People with disabilities; Psychosis; Psychotropic drugs; Schizophrenia; treatment persistence; Welfare; Well being
• ISSN: 1177-889X; 1177-889X
• DOI: 10.2147/PPA.S282958

One of the challenges of treating schizophrenia is how to improve persistence with outpatient treatments. Lengthening community life by improving persistence and preventing relapse and rehospitalization can have positive influence on the patients' personal recovery and well-being. In Japan, there is "Medical Expenses for Services and Supports for Persons with Disabilities" ("Jiritsu-shien-iryo-hi" in Japanese) which is the public financial support system for psychiatric outpatient treatments. However, it is not clear how this financial support affects persistence with outpatient treatments for patients with schizophrenia. The purpose of the study is to investigate how the financial support affects persistence with outpatient treatments for schizophrenia. Data of outpatients who visited the clinic between October 1, 2006 and September 30, 2016 was collected. The variables for the analysis were continuation and discontinuation of treatment of those who used the financial support (user) and those who did not (nonuser). The covariates were sex, age, time from onset of the disease to first visit to the clinic, number of hospitalizations in the past, use of psychiatric day care, and use of psychiatric home nursing care. Kaplan-Meier analysis was performed using propensity score matching. The observation period was five years from the first visit to the clinic. Among 1155 patients who were diagnosed with schizophrenia, 718 were excluded, based on the exclusion criteria. The propensity score matching was performed for 437 patients, and the subjects for the final analysis were 278. Average survival period was 1.09 (SD ±1.66) years for nonuser, 3.02 (SD ±1.77) years for users, and users exhibited a significantly longer number of years of outpatient treatments (