Health  Vol.9 No.4 , April 2017
Health Resource Utilization and Comorbidities in Patients with Mental Disorders: Analysis Based on Health Insurance Claim Data
The number of patients with mental disorders is increasing all over the world and they have a high prevalence of physical complications. To analyze and compare the cost of mental disorders with the total medical costs such as mental disorders and physical disorders, we analyzed the cost that patients with mental disorders incurred. We investigated the distribution of medical costs and the characteristics of diseases by using the health insurance claims of people in City A, Japan from March 2013 to February 2014. The subjects had one or more of 4 mental disorders: schizophrenia, alcohol related disorders, bipolar disorder, and depressive episode. As a result, the total number of patients who met inclusion criteria per year was 7403 (6522 outpatients and 881 inpatients). It was revealed that the hospitalization rate of patients with mental disorders increased with age, and many inpatients stayed in hospital for a long time. Also, it was revealed that many patients with mental disorders were in complicated condition with more than one mental or physical disorders and incurred medical costs for these comorbidities. In conclusion, this analysis indicated that many patients with mental disorders switch from attending the outpatient department to hospitalization as they become older. Further, they incurred a lot of medical expenses for complication management. To improve their QOL, comprehensive assessment of their mental/ physical health, self-management education, coordination of services, and support for decision making regarding treatment are necessary.
Cite this paper: Kazawa, K. , Iwamoto, S. , Rahman, M. and Moriyama, M. (2017) Health Resource Utilization and Comorbidities in Patients with Mental Disorders: Analysis Based on Health Insurance Claim Data. Health, 9, 763-777. doi: 10.4236/health.2017.94055.

[1]   Kessler, R.C., Aguilar-Gaxiola, S., Alonso, J., Chatterji, S., Lee, S., Ormel, J., et al. (2009) The Global Burden of Mental Disorders: An Update from the WHO World Mental Health (WMH) Surveys. Epidemiologia e Psichiatria Sociale, 18, 23-33.

[2]   OECD Health Statistics (2016) Care for People with Mental Health Disorders.

[3]   Ministry of Health, Labour and Welfare (2016) Patient Survey (Disease and Injury).

[4]   Kawakami, N., Takeshima, T., Ono, Y., Uda, H., Hata, Y., Nakane, Y., et al. (2005) Twelve-Month Prevalence, Severity, and Treatment of Common Mental Disorders in Communities in Japan: Preliminary Finding from the World Mental Health Japan Survey 2002-2003. Psychiatry and Clinical Neurosciences, 59, 441-452.

[5]   Crown, W.H., Neslusan, C., Russo, P.A., Holzer, S., Ozminkowski, R. and Croghan, T. (2001) Hospitalization and Total Medical Costs for Privately Insured Persons with Schizophrenia. Administration and Policy in Mental Health, 28, 335-351.

[6]   Matsuda, S. (2009) Demographic Characteristics and Its Impact on Health Policy in Japan. Asian Pacific Journal of Disease Management, 3, 91-97.

[7]   Ministry of Health, Labour and Welfare (2009) Summary about Corresponding for Suicide and Depression etc by Project Team.

[8]   Sobocki, P., Jönsson, B., Angst, J. and Rehnberg, C. (2007) Cost of Depression in Europe. The Journal of Mental Health Policy and Economics, 9, 87-98.

[9]   Sado, M., Yamauchi, K., Kawakami, N., Ono Y., Furukawa, T.A., Tsuchiya, M., et al. (2011) Cost of Depression among Adults in Japan in 2005. Psychiatry and Clinical Neurosciences, 65, 442-450.

[10]   Chang, S.M., Cho, S.J., Jeon, H.J., Hahm, B.J., Lee, H.J., Park, J.I., et al. (2012) Economic Burden of Depression in South Korea. Social Psychiatry and Psychiatric Epidemiology, 47, 683-689.

[11]   Kessler, R.C. (2012) The Costs of Depression. Psychiatric Clinics of North America, 35, 1-14.

[12]   Sado, M., Inagaki, A., Koreki, A., Knapp, M., Kissane, L.A., Mimura, M., et al. (2013) The Cost of Schizophrenia in Japan. Neuropsychiatric Disease and Treatment, 9, 787-798.

[13]   Osaki, Y. (2015) Epidemiology and Societal Costs of Alcohol Disorders. Journal of Clinical and Experimental Medicine, 254, 896-900. (In Japanese)

[14]   Alexandre, P.K., Hwang, S., Roth, K.B., Gallo, J.J. and Eaton, W.W. (2016) Costs of Depression from Claims Data for Medicare Recipients in a Population-Based Sample. Journal of Health and Human Services Administration, 39, 72-94.

[15]   Krishnan, K.R. (2005) Psychiatric and Medical Comorbidities of Bipolar Disorder. Psychosomatic Medicine, 67, 1-8.

[16]   McIntyre, R.S., Nguyen, H.T., Soczynska, J.K., Lourenco, M.T., Woldeyohannes, H.O. and Konarski, J.Z. (2008) Medical and Substance-Related Comorbidity in Bipolar Disorder: Translational Research and Treatment Opportunities. Dialogues in Clinical Neuroscience, 10, 203-213.

[17]   Fagiolini, A. and Goracci, A. (2009) The Effects of Undertreated Chronic Medical Illnesses in Patients with Severe Mental Disorders. Journal of Clinical Psychiatry, 70, 22-29.

[18]   Ettner, S.L., Azocar, F., Branstrom, R.B., Meredith, L.S., Zhang, L. and Ong, M.K. (2010) The Association of General Medical and Psychiatric Comorbidities with Receipt of Guideline-Concordant Care for Depression. Psychiatric Services, 61, 1255-1259.

[19]   Regional Medical Information System (2015). (In Japanese)

[20]   Ministry of Health, Labour and Welfare (2017) Report of Bed Categories.

[21]   United States Renal Data System (2016) Annual Data Report 2016.

[22]   Bender, A. and Farvolden, P. (2008) Depression and the Workplace: A Progress Report. Current Psychiatry Reports, 10, 73-79.

[23]   Birnbaum, H.G., Kessler, R.C., Kelley, D., Ben-Hamadi, R., Joish, V.N. and Greenberg, P.E. (2010) Employer Burden of Mild, Moderate, and Severe Major Depressive Disorder: Mental Health Services Utilization and Costs, and Work Performance. Depression and Anxiety, 27, 78-89.

[24]   Ministry of Health, Labour and Welfare (2014) Current Condition of Psychiatric Patients Hospitalized for an Extended Period.

[25]   Kanata, T. (2016) Japanese Mental Health Care in Historical Context: Why Did Japan Become a Country with So Many Psychiatric Care Beds? Social Work, 52, 471-489.

[26]   Ikegami, N. and Ikezaki, S. (2010) Life Sustaining Treatment at end-of-Life in Japan: Do the Perspectives of the General Public Reflect Those of the Bereaved of Patients Who Had Died in Hospitals? Health Policy, 98, 98-106.

[27]   World Health Organization (2010) World Health Statistics 2010. 155-167.

[28]   Cabinet Office (2015) White Paper on Aging of Society 2015.

[29]   Ukai, K., Mizuno, Y., Ozaki, K., Sekiya, T., Tomita, K. and Ito, T. (2007) Physical Complications of Dementia. 12 Months Research in a Special Ward for the Elderly with Senile Dementia. Psychogeriatrics, 7, 21-24.

[30]   Gurgu, M., Zamfirescu, A., Rascu, A., Romila, A., Gurgu, H. and Nedelcu, L. (2014) Role of Comorbidities in Caring for Chronicly Ill Elderly Patients with and without Dementia. Clujul Medical, 87, 102-105.

[31]   Spruytte, N., Andenhove, C.V. and Lammertyn, F. (2001) Predictors of Institutionalization of Cognitively-Impaired Elderly Cared for by Their Relatives. International Journal of Geriatric Psychiatry, 16, 1119-1128.

[32]   Ono, T., Tamai, A., Takeuchi, D. and Tamai, Y. (2010) Predictors of Outcomes from Award for Demented Elderly Gender Differences. Psychogeriatrics, 10, 21-28.

[33]   Ono, T., Tamai, A., Takeuchi, D., Tamai, Y., Iseki, H., Fukushima, H., et al. (2010) Predictors of Length of Stay in Award Demented Elderly: Gender Differences. Psychogeriatrics, 10, 153-159.