Health Service Utilization and Costs among Patients with Schizophrenia Receiving Long-Acting Injectable Risperidone and Medical-Decision Making in Prescribing Long -Acting Injectable Antipsychotics by Psychiatrists

According to health statistics, in Taiwan, the number of patients with schizophrenia is increasing yearly, and those patients consume lots of medical care resources. One of the new developments regarding treating psychotics is long-acting injectable (LAI) antipsychotics. However, the issues of health service utilization and costs among patients with schizophrenia receiving LAI, and medical-decision making in prescribing LAI by psychiatrists remain under-recognized. Hence, the two-year research proposal aims to probe the note-above questions. The research methods are illustrated as follows: The First Year: The aim of the first year’s project is to compare health service utilization and costs between patients with schizophrenia receiving LAI (the case cohort) and those receiving the oral form (the control cohort). A retrospective matched case-control study design is utilized. The main data source is the 2008-2013 Psychiatric Inpatient Medical Claim Dataset (PIMC). With respect to data analyses, Propensity Score Matching (PSM) and Generalized Estimating Equation (GEE) will be performed. The Second Year: The research objective of the second year’s project is to assess the influencing factors of medical-decision making in prescribing LAI by psychiatrists. The survey subjects are all practicing psychiatrists in Taiwan. Structured self-administered questionnaires will be mailed to all subjects. Statistical analyses will include descriptive statistics, chi-squared test and logistics regression analysis for quantitative data (from survey), and content analysis for qualitative data (from in-depth interview). The main statistical methods will be multiple regression analysis and logistic regression analysis. In conclusion, research findings of the two-year project would provide empirical evidence in helping the medical professional design better clinical guidelines; as such, improve health care quality of treating psychotics.