Schizophrenia Related Hospitalizations – a Big Data Analysis of a National Hospitalization Database

Abstract

Schizophrenia is a mental disorder characterized by long hospitalizations and frequent need for chronic/acute psychiatric care. Hospitalizations represent a valuable quality of care indicator in schizophrenia patients. The aim of this study was to describe a nationwide perspective of schizophrenia related hospitalizations. We performed a retrospective observational study using a nationwide hospitalization database containing all hospitalizations registered in Portuguese public hospitals from 2008 to 2015. Hospitalizations with a primary diagnosis of schizophrenia were selected based on the definition by CCS – Clinical Classification Software diagnostic single-level 659. Schizophrenia subtypes were identified based on International Classification of Diseases version 9, Clinical Modification (ICD-9-CM) codes of diagnosis 295.xx. A total of 25,385 hospitalizations were registered belonging to 14,279 patients. 68.0% of the hospitalizations occurred in male patients and the median length of stay was 18.0 days. In male patients’ hospitalizations, the most frequent age group was 31–50 years followed by the age group of 18–30 years (55.9 and 24.0% respectively). For female patients, the most frequent age group was 31–50 years followed by 51–70 years (54.1 and 22.6%, respectively). There were 73 hospitalization with a deadly outcome (0.29%). Paranoid type was the most frequent subtype of schizophrenia (50.5%). The mean hospitalization charges were 3509.7€ per episode, with a total charge of 89.1 M€ in the 8-year period. This is a nationwide study using Big Data analysis giving a broad perspective of schizophrenia hospitalization panorama at a nationwide level. We found differences in hospitalization characteristics according to patients’ gender, age and primary diagnosis.

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Acknowledgements

We would like to acknowledge ACSS for providing the administrative data on hospitalisations and Fernando Lopes, MD, for his support throughout the elaboration of the study and his valuable help in ICD-9-CM(International Classification of Diseases version 9, Clinical Modification) codification detailing.

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Author Manuel Gonçalves-Pinho designed the study and participated in all phases of the study. Author João Ribeiro participated in the clinical analyses and writing of the paper. Authors Manuel Gonçalves-Pinho and Alberto Freitas undertook the statistical analysis, and author Manuel Gonçalves-Pinho wrote the first draft of the manuscript. All authors contributed to and have approved the final manuscript.

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Correspondence to Manuel Gonçalves-Pinho.

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The data used was given by a Portuguese governmental agency guaranteeing all identification information was anonymous.

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No informed consent was needed once we used an administrative database built for hospital billing with no access to patients identification.

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Gonçalves-Pinho, M., Ribeiro, J.P. & Freitas, A. Schizophrenia Related Hospitalizations – a Big Data Analysis of a National Hospitalization Database. Psychiatr Q 92, 239–248 (2021). https://doi.org/10.1007/s11126-020-09793-8

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Keywords

  • Schizophrenia
  • Mental disorders
  • Psychosis
  • Big data
  • Patient admission
  • Administrative data