Background
Methods
Data source
Study design
Study end points
Matching algorithm
Statistical analysis
Results
Baseline characteristics
Variable | Atypical LAT | Oral AP |
pvalue1
|
---|---|---|---|
(N = 1032) | (N = 2796) | ||
Age, mean ± SD [median]
| 42.1 ± 14.4 [42.5] | 42.4 ± 13.7 [43.0] | .5622 |
Female,
n
(%)
| 450 (43.6) | 1246 (44.6) | .5345 |
Marital status,
n
(%)
| |||
Single | 869 (84.2) | 2364 (84.5) | .8531 |
Married | 70 (6.8) | 171 (6.1) | .3501 |
Other | 93 (9.0) | 260 (9.3) | .3217 |
Unknown | 0 (0.0) | 1 (0.0) | - |
Race,
n
(%)
| |||
White | 483 (46.8) | 1302 (46.6) | .8515 |
Black | 327 (31.7) | 908 (32.5) | .4751 |
Hispanic | 29 (2.8) | 77 (2.8) | .7488 |
Other | 193 (18.7) | 509 (18.2) | .6339 |
Primary payer type,
n
(%)
| |||
Medicare | 509 (49.3) | 1429 (51.1) | .1455 |
Medicaid | 327 (31.7) | 864 (30.9) | .3670 |
Commercial indemnity | 39 (3.8) | 96 (3.4) | .6600 |
Self-pay | 32 (3.1) | 77 (2.8) | .6265 |
Managed care | 68 (6.6) | 183 (6.5) | .8717 |
Other | 57 (5.5) | 147 (5.3) | .6385 |
Hospital characteristics,
n
(%)
| |||
Urban | 920 (89.1) | 2512 (89.8) | .4343 |
Teaching | 422 (40.9) | 1195 (42.7) | .1380 |
Large (≥500 beds) | 311 (30.1) | 875 (31.3) | .2576 |
Region of the hospital,
n
(%)
| |||
South | 438 (42.4) | 1151 (41.2) | .5484 |
Midwest | 247 (23.9) | 703 (25.1) | .6391 |
West | 187 (18.1) | 491 (17.6) | .3662 |
Northeast | 160 (15.5) | 451 (16.1) | .2229 |
Admission source,
n
(%)
| |||
Physician referral | 294 (28.5) | 761 (27.2) | .2282 |
ER | 547 (53.0) | 1530 (54.7) | .2747 |
Clinic referral | 18 (1.7) | 63 (2.3) | .1819 |
Court/law enforcement | 26 (2.5) | 56 (2.0) | .2773 |
Transfer from hospital | 80 (7.8) | 210 (7.5) | .7994 |
Other | 67 (6.5) | 176 (6.3) | .9110 |
Admitting physician specialty,
n
(%)
| |||
Psychiatry | 935 (90.6) | 2579 (92.2) | .3415 |
Internal medicine (internist/hospitalist) | 13 (1.3) | 34 (1.2) | .8026 |
Family/General medicine | 6 (0.6) | 25 (0.9) | .1495 |
Other | 76 (7.4) | 158 (5.7) | .1448 |
Unknown | 2 (0.2) | 0 (0.0) | - |
Attending physician specialty,
n
(%)
| |||
Psychiatry | 985 (95.4) | 2702 (96.6) | .0366 |
Internal medicine (internist/hospitalist) | 12 (1.2) | 32 (1.1) | .9013 |
Family/General medicine | 3 (0.3) | 6 (0.2) | .4054 |
Other | 32 (3.1) | 56 (2.0) | .0258 |
Most frequent admitting diagnoses,
n
(%)
| |||
Schizophrenia3
| 627 (60.8) | 1721 (61.6) | .5098 |
Other mental disorders4
| 150 (14.5) | 403 (14.4) | .9093 |
Injury and poisoning7
| 4 (0.4) | 5 (0.2) | .0896 |
Other | 21 (2.0) | 61 (2.2) | .9263 |
Unknown | 230 (22.3) | 606 (21.7) | .5012 |
Most frequent primary diagnoses,
n
(%)
| |||
Schizophrenia3
| 976 (94.6) | 2686 (96.1) | .0897 |
Paranoid (ICD-9-CM: 295.3) | 426 (43.6) | 1165 (43.4) | .7467 |
Schizoaffective disorder (ICD-9-CM: 295.4) | 370 (37.9) | 1047 (39.0) | .4872 |
Unspecified (ICD-9-CM: 295.9) | 80 (8.2) | 209 (7.8) | .8782 |
Residual (ICD-9-CM: 295.6) | 62 (6.4) | 162 (6.0) | .4025 |
Other | 38 (3.9) | 103 (3.8) | .6650 |
Other mental disorders4
| 46 (4.5) | 90 (3.2) | .2541 |
Diseases of the circulatory system5
| 0 (0.0) | 1 (0.0) | - |
Injury and poisoning6
| 8 (0.8) | 12 (0.4) | .0455 |
Other | 2 (0.2) | 7 (0.3) | .7815 |
Degree of severity,
n
(%)
7
| |||
Minor | 284 (27.5) | 764 (27.3) | .6578 |
Moderate | 680 (65.9) | 1847 (66.1) | .9115 |
Major | 60 (5.8) | 160 (5.7) | .7687 |
Extreme | 8 (0.8) | 25 (0.9) | .3657 |
Number of distinct APs used, mean ± SD [median]
2
| 2.2 ± 1.0 [2.0] | 2.2 ± 1.0 [2.0] | 1.0000 |
Suicidal behavior,
n
(%)
8
| 115 (11.1) | 303 (10.8) | .6393 |
Surgery during index hospitalization,
n
(%)
| 21 (2.0) | 76 (2.7) | .0518 |
Discharge status,
n
(%)
| |||
Home | 853 (79.4) | 2425 (80.4) | .1478 |
Transferred to hospice, rehabilitation center, or nursing home | 64 (6.9) | 230 (7.6) | .3959 |
Discharged/transferred to psychiatric facility | 46 (4.5) | 153 (5.1) | .0825 |
Other/Unknown | 69 (6.7) | 207 (6.9) | .9592 |
Length of stay, days, mean ± SD [median]
| 16.3 ± 19.4 [11.0] | 16.0 ± 22.3 [10.0] | .6142 |
Time between first hospitalization and index hospitalization, months, mean ± SD [median]
| 8.0 ± 10.2 [3.0] | 7.5 ± 9.8 [3.0] | .1186 |
Time between index hospitalization and data cutoff date, months, mean ± SD [median]
| 29.8 ± 16.1 [29.0] | 30.3 ± 16.1 [29.0] | .2953 |
Year of admission,
n
(%)
| |||
2006 | 200 (19.4) | 550 (19.7) | .7883 |
2007 | 189 (18.3) | 548 (19.6) | .1657 |
2008 | 228 (22.1) | 603 (21.6) | .3887 |
2009 | 241 (23.4) | 656 (23.5) | .9749 |
2010 | 174 (16.9) | 439 (15.7) | .4453 |
Rehospitalizations and emergency room visits
Atypical LAT | Oral AP |
pvalue1
| |
---|---|---|---|
(N = 1032) | (N = 2796) | ||
Rehospitalizations
| |||
All-cause rehospitalizations
| |||
Number of rehospitalizations, mean ± SD | 1.25 ± 2.09 | 1.61 ± 2.82 | <.0001 |
Mean number of days in hospital, mean ± SD | 13.46 ± 27.48 | 15.69 ± 30.49 | .0081 |
Time to first rehospitalization, months, mean ± SD | 7.47 ± 9.30 | 7.04 ± 8.86 | .2362 |
Frequency of rehospitalizations, mean ± SD | |||
Within the same month | 0.07 ± 0.27 | 0.09 ± 0.31 | .0688 |
By 1 month | 0.15 ± 0.41 | 0.20 ± 0.49 | .0286 |
By 3 months | 0.30 ± 0.62 | 0.38 ± 0.76 | .0288 |
By 6 months | 0.48 ± 0.84 | 0.58 ± 1.05 | .0029 |
Mental disorder–related rehospitalizations
2
| |||
Number of rehospitalizations, mean ± SD | 1.24 ± 2.08 | 1.59 ± 2.79 | <.0001 |
Mean number of days in hospital, mean ± SD | 13.44 ± 27.46 | 15.62 ± 30.41 | .0093 |
Time to first rehospitalization, months, mean ± SD | 7.46 ± 9.31 | 7.02 ± 8.84 | .2451 |
Frequency of rehospitalizations, mean ± SD | |||
Within the same month | 0.07 ± 0.27 | 0.09 ± 0.31 | .0786 |
By 1 month | 0.15 ± 0.41 | 0.20 ± 0.49 | .0360 |
By 3 months | 0.30 ± 0.62 | 0.37 ± 0.76 | .0333 |
By 6 months | 0.48 ± 0.84 | 0.58 ± 1.05 | .0032 |
Schizophrenia–related rehospitalizations
3
| |||
Number of rehospitalizations, mean ± SD | 1.15 ± 2.00 | 1.41 ± 2.54 | .0005 |
Mean number of days in hospital, mean ± SD | 12.79 ± 27.07 | 14.28 ± 29.14 | .0893 |
Time to first rehospitalization, months, mean ± SD | 7.39 ± 9.32 | 7.16 ± 8.99 | .4063 |
Frequency of rehospitalizations, mean ± SD | |||
Within the same month | 0.06 ± 0.25 | 0.08 ± 0.29 | .0854 |
By 1 month | 0.14 ± 0.39 | 0.18 ± 0.46 | .1834 |
By 3 months | 0.28 ± 0.60 | 0.34 ± 0.72 | .2080 |
By 6 months | 0.45 ± 0.81 | 0.52 ± 0.97 | .0947 |
ER Visits
| |||
All-cause ER visits
| |||
Number of ER visits, mean ± SD | 2.33 ± 5.58 | 2.67 ± 6.38 | .0158 |
Time to first ER visit, months, mean ± SD | 6.91 ± 8.82 | 6.79 ± 8.84 | .6060 |
Frequency of ER visits, mean ± SD | |||
Within the same month | 0.08 ± 0.31 | 0.09 ± 0.34 | .4026 |
By 1 month | 0.21 ± 0.60 | 0.25 ± 0.66 | .0482 |
By 3 months | 0.44 ± 1.18 | 0.50 ± 1.15 | .1375 |
By 6 months | 0.75 ± 1.84 | 0.78 ± 1.61 | .3822 |
Mental disorder–related ER visits
2
| |||
Number of ER visits, mean ± SD | 1.95 ± 4.73 | 2.08 ± 4.33 | .0881 |
Time to first ER visit, months, mean ± SD | 7.41 ± 9.27 | 7.34 ± 9.41 | .6870 |
Frequency of ER visits, mean ± SD | |||
Within the same month | 0.07 ± 0.28 | 0.08 ± 0.30 | .5467 |
By 1 month | 0.18 ± 0.54 | 0.21 ± 0.55 | .2015 |
By 3 months | 0.38 ± 1.03 | 0.41 ± 0.94 | .4573 |
By 6 months | 0.64 ± 1.46 | 0.64 ± 1.29 | .6932 |
Schizophrenia–related ER visits
3
| |||
Number of ER visits, mean ± SD | 1.50 ± 3.36 | 1.54 ± 3.22 | .2637 |
Time to first ER visit, months, mean ± SD | 7.77 ± 9.57 | 7.73 ± 9.56 | .7920 |
Frequency of ER visits, mean ± SD | |||
Within the same month | 0.06 ± 0.26 | 0.06 ± 0.27 | .5023 |
By 1 month | 0.15 ± 0.47 | 0.16 ± 0.45 | .5133 |
By 3 months | 0.31 ± 0.90 | 0.32 ± 0.77 | .8963 |
By 6 months | 0.50 ± 1.21 | 0.50 ± 1.04 | .8894 |