Profile of Brazilian Inpatients With Mental Disorders Covered By Private Health Care In The State of Ceara: A Real World Data Analysis

• Published in: Value in health 2017-10, Vol.20 (9), p.A712-A713
• Main Authors: Ad, Viana, Viana, JL, Ferreira, KA, Silva, MO, Viana, JF, Albuquerque, IM, Vd, Neto, Landim, RM, Matias, C, Sartori, DP, Vieira, JB, Ximenes, E, Junior, AN, Moreira, V
• Format: Article
• Language: English
• Subjects: Antipsychotics; Averages; Data processing; Drug prices; Economic impact; Fees & charges; Health care expenditures; Health insurance; Help seeking behavior; Hospitalization; Hospitals; Injunctions; Inpatient care; Length of stay; Males; Medical treatment; Mental disorders; Perceptions; Private medical care; Psychiatric hospitals; Psychiatric-mental health nursing; Schizophrenia; Special hospitals
• ISSN: 1098-3015; 1524-4733
• DOI: 10.1016/j.jval.2017.08.1887

OBJECTIVES: The costs of psychiatric hospitalizations are a challenge to Brazilian Private Health care Insurance (PHI) due to the difficulty of de-hospitalizing these patients. There is a perception that psychiatric inpatients usually stay longer than others, generating significant economic impact for PHIs. Our objective was to identify the profile of these patients, the costs and average length of stay of patients who stay hospitalized longer than 100 days. METHODS: It was conducted an observational study. Clinical and economic data were obtained from a Brazilian Medical cooperative PHI database. Inclusion criteria: age > 18 years old, diagnose of psychiatric disorder and length of stay longer than 100 days at psychiatric hospitals. Inpatients hospitalized from May 12, 2006 to March 31, 2017 were included. This PHI cover 342.757 clients in Ceara - Brazil. Data was collected of the total inpatient costs, health care resources utilization and length of stay (LOS). RESULTS: A total of 36 inpatients met our inclusion criteria. The majority was male (n=25/ 69.44%). 68% of male patients have 25 to 44 years old (n=17) and 81.82% of female have 35 to 54 years (n=9). The CID-10 more frequent on males was F-20-Schizophrenia (n=20/ 80%). Among females, F-20 represented 36.4% (n=4). Antipsychotics were the medication used more frequently (43.74%), representing 75.49% of medication costs (U$202.082,79). The total hospitalization cost was U$2.802.397,34 without medical fees and the average was U$77.844,37. The total LOS was 29,390 days and the average 816,9 days (max. 3.976 days). Four patients obtained judicial injunctions allowing them to stay at psychiatric hospitals CONCLUSIONS: Psychiatric hospitalizations are a challenge to brazilian PHI, demanding special attention due the long LOS and high cost of hospitalizations. In addition, these patients are usually male diagnosed with schizophrenia at productive working-age. Strategies which could decrease LOS and consequently hospitalization costs, could benefit PHIs, patients and families.