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Table 4 Association between the category of mental disorders, mortality, and total medical expenditures per capita, controlling for all other variables (Cox proportional hazard model and GLM, N = 285,125)

From: Identification of psychiatric patients with high mortality and low medical utilization: a population-based propensity score-matched analysis

Variables

Death per 1000 person-days

Death

P-value

Mean of total medical expenditures (USD)

P-value

Adjusted HR

95% CI

Health and Medication Conditions

Category of mental disorders

< 0.0001*

  Affective disorders

0.0617

1.246

1.180–1.316

< 0.0001*

15,791.06

 

  Anxiety disorders

0.0335

–

–

–

12,618.92

 

  Substance use disorders

0.0500

1.064

1.009–1.122

0.0231*

13,307.55

 

  Schizophrenia

0.0685

1.072

0.923–1.245

0.3646

29,748.05

 

  Other disorders

0.0546

1.233

1.195–1.271

< 0.0001*

13,016.03

 

Multiple diagnoses

< 0.0001*

  Present

0.0488

–

–

–

17,275.36

 

  Absent

0.0421

1.095

1.062–1.130

< 0.0001*

16,517.29

 

Involuntary hospitalization

< 0.0001*

  Present

0.0892

–

–

–

28,345.00

 

  Absent

0.0443

1.417

0.988–2.032

0.0579

5447.64

 

Comorbidity (CCI)

0.4944

  0

0.0212

–

–

–

16,887.48

 

  1

0.0744

1.004

0.970–1.040

0.8134

16,869.13

 

   ≥ 2

0.1825

1.178

1.126–1.233

< 0.0001*

16,932.35

 

Use of psychiatric medication

< 0.0001*

  Mood stabilizer

0.0503

1.061

1.025–1.098

0.0007*

16,743.08

 

  Antidepressants

0.0365

1.057

0.968–1.153

0.2169

16,357.20

 

  Antipsychotics

0.0579

1.237

1.152–1.330

< 0.0001*

16,591.78

 

  Multiple categories

0.0763

–

–

–

18,354.09

 

  None

0.0274

1.213

1.166–1.261

< 0.0001*

16,435.46

 

Demographics

Gender

< 0.0001*

  Male

0.0578

1.039

1.009–1.069

0.0104*

17,058.96

 

  Female

0.0333

–

–

–

16,733.68

 

Age (years)

< 0.0001*

   < 19

0.0035

–

–

–

16,905.26

 

  20–34

0.0105

1.760

1.460–2.122

< 0.0001*

16,768.65

 

  35–49

0.0187

2.143

1.789–2.567

< 0.0001*

16,892.76

 

  50–64

0.0238

1.915

1.598–2.294

< 0.0001*

16,847.92

 

   ≥ 65

0.1458

1.809

1.514–2.162

< 0.0001*

17,067.00

 

Occupationa

< 0.0001*

  First category

0.0327

1.073

1.021–1.127

0.0053*

16,757.76

 

  Second category

0.0318

–

–

–

16,719.60

 

  Third category

0.0847

1.066

1.011–1.124

0.0180*

16,749.59

 

  Fourth category

0.0338

1.058

0.817–1.371

0.6670

16,464.26

 

  Fifth category

0.1031

1.193

1.029–1.382

0.0190*

17,809.09

 

  Sixth category

0.0814

1.065

1.003–1.130

0.0400*

16,877.63

 

Premium-based monthly salary (USD)

< 0.0001*

   ≤ 576

0.0407

1.095

0.987–1.214

0.0857

17,166.44

 

  576–760

0.0622

1.079

0.967–1.205

0.1755

17,050.43

 

  760–960

0.0277

1.185

1.038–1.352

0.0119*

16,888.68

 

  960–1210

0.0322

1.064

0.938–1.208

0.3322

16,879.77

 

  1210–1526

0.0264

1.024

0.895–1.171

0.7319

16,713.87

 

  > 1526

0.0198

–

–

–

16,678.74

 

Provider Features

Level of hospital

< 0.0001*

  Medical center

0.0478

1.123

1.068–1.181

< 0.0001*

17,468.25

 

  Regional hospital

0.0550

1.200

1.146–1.256

< 0.0001*

17,110.40

 

  District hospital

0.0644

1.101

1.056–1.148

< 0.0001*

16,871.55

 

  Clinic

0.0295

–

–

–

16,135.08

 

Ownership of Hospital

< 0.0001*

  Public

0.0625

1.013

0.972–1.056

0.5297

17,341.45

 

  Private

0.0359

–

–

–

16,581.21

 

  Consortium

0.0464

1.012

0.968–1.058

0.6082

16,605.31

 

 Association

0.0669

1.139

1.044–1.243

0.0035*

17,057.32

 

Psychiatrist’s year of practice

< 0.0001*

   ≤ 5

0.0484

1.709

1.629–1.793

< 0.0001*

16,838.19

 

  6–10

0.0436

1.237

1.193–1.283

< 0.0001*

16,843.31

 

  11–15

0.0445

1.020

0.980–1.062

0.3206

16,938.61

 

   ≥ 16

0.0423

–

–

–

16,965.18

 

Geographic Characteristics

Region

0.1356

  Taipei

0.0388

–

–

–

16,906.41

 

  Northern

0.0455

1.009

0.959–1.062

0.7265

16,897.61

 

  Central

0.0433

1.028

0.982–1.076

0.2401

16,819.57

 

  Southern

0.0516

1.087

1.036–1.142

0.0008*

16,891.88

 

  Southeast

0.0480

1.014

0.970–1.061

0.5367

16,878.81

 

  Eastern

0.0617

1.141

1.043–1.247

0.0038*

16,983.65

 

Urbanization level

0.7318

  Level 1 (Highest)

0.0361

1.063

0.976–1.158

0.1597

16,906.04

 

  Level 2

0.0405

1.080

0.996–1.171

0.0636

16,912.38

 

  Level 3

0.0435

1.069

0.984–1.161

0.1131

16,921.85

 

  Level 4

0.0541

1.050

0.970–1.136

0.2301

16,851.65

 

  Level 5

0.0688

–

–

–

16,928.21

 

  Level 6

0.0730

1.081

0.989–1.182

0.0855

16,872.15

 

  Level 7 (Lowest)

0.0645

1.114

1.013–1.224

0.0264*

16,881.97

 
  1. * P < 0.05
  2. HR hazard ratio
  3. a First category includes private employees and public servants; Second category includes labor union members; Third category includes farmers and fishermen; Fourth category includes soldiers; Fifth category includes social security insureds; Sixth category includes veterans and religious group members