Researchers: Amir Krivoy¹, Moshe Hoshen², Mark Weiser³

Background: Schizophrenia patients have expetional high rates of physical comorbidity and reduced life span of 15-20 years. Although morbidity is mostly of preventable illnesses, it is not clear where to invest resources to optimize outcomes

Objectives: To explore the rates of mortality, preventable physical comorbidity and health resource utilization in schizophrenia compared to non-schizophrenia control. Eventually to assess health costs distribution between treatment medical levels.

Method: A retrospective, three years follow-up study of patients (N=29,483) versus non-schizophrenia controls (N=2,338,968). Variables of mortality, morbidity, service use and health cost were retrieved and compared between groups. Based on data, a model of health expenditure on primary, secondary and tertiary services was developed.

Findings: Adjusted risk ratio for mortality was 3.53, with reduced life expectancy of 11.4 for females and 13.8 for males. Higher rates of physical comorbidity and low rate health resource utilization were found among schizophrenia patients. The additive cost of physical illness is up to 6-folds while patients have higher portion of cost on tertiary medical services.

Conclusions: Schizophrenia patients in Israel are more physically ill and use less primary medical resources, they die younger and in higher rates than non-schizophrenia controls. Patients are admitted to hospital more frequently, more ill, for longer periods. While physical comorbidity increase costs by up to 6-folds, the expenditure on health is more on tertiary medical services.

Recommendations: A holistic, integrative plan should be put in place in primary medicine resources to detect and monitor physical health needs in schzizophrenia population,health resource investment should be redirected towards primary services and improving life style, thus potentially reducing the rates of physical health burden and consequently mortality

Research end date: 04/2017