Gender-based Policies to Reduce Hospitalization in Schizophrenia

Michael Durkin, Jefferson School of Population Health, Thomas Jefferson University


V Maio, School of Population Health, Thomas Jefferson University, Philadelphia, PA.


Frequent hospitalizations in patients with schizophrenia remain a significant problem in terms of cost and patient experience for behavioral health organizations. The purpose of this project was to identify factors associated with hospitalization in schizophrenia for men and for women and to recommend gender-specific policies to reduce hospitalization. Data from an online survey of schizophrenia patients were analyzed to compare cohorts defined by gender and by hospitalization in the last six months. Patient attributes qualitatively selected as potential predictors of hospitalizations (hospitalization factors) and as relevant to policy or program implementation (policy factors) were compared between cohorts using chi square tests at significance p<0.01. Logistic regression models were used to quantify the association of hospitalization factors to the dependent variable hospitalization for males and for females. Based on these univariate and multivariate results, policy recommendations were derived for the identification of at-risk patients and for the design of more effective hospitalization reduction policies. Females comprised 52% of the 1083 survey respondents and had a higher hospitalization rate than males (25.6% vs. 23.0%, p=0.052). Factors associated with hospitalization for females included race/ethnicity and living situation, while factors for males included age and education. In terms of policy factors, 85.7% of hospitalized females were interested in reminder calls for appointments, while their male counterparts reported preferences for prescription reminders (71.5%) and disease education (67.5%). Independent of gender, a higher proportion of hospitalized patients reported that their co-pay for antipsychotic medication was a burden (35.0% vs. 25.6%, p=0.002) than those not hospitalized. Study findings support the use of gender-specific factors to identify schizophrenia patients at risk of hospitalization and the potential for improved effectiveness of mental health services through gender-specific policies. Further research is needed replicating these analyses in other schizophrenia populations or drawing from other data sources.

Presentation: 33 minutes