Online Program

Burden of medical co-morbidity in men and women with serious mental illness

Tuesday, November 5, 2013 : 1:30 p.m. - 1:45 p.m.

Kathryn Parr, PhD, School of Social Work, University of Connecticut, West Hartford, CT
Frank Baker, PhD, CT Department of Mental Health and Addictions Services, Hartford, CT
Megan Ehret, PharmD, MS, BCPP, Pharmacy Practice, University of Connecticut, Storrs, CT
Research shows that persons with serious mental illness (SMI) are at greater risk for chronic medical conditions and lower life expectancies because of health risks associated with atypical antipsychotics and lifestyles (Chang et al., 2011) This analysis uses administrative data from Medicaid claims data linked to the Connecticut Department of Mental Health and Addiction Services data system to examine service use, medical co-morbidities and Medicaid costs for individuals with schizophrenia, bi-polar disorder, major depressive disorder and other psychoses. Some health conditions show higher prevalence among the SMI population--such as cancer (7.4% vs 6.6% p=0.000) and diabetes (16.5% vs 6.5% p=0.000). The average medical Medicaid costs for individuals with SMI for these conditions are $5,306 and $2,336 respectively - both lower than expenditures for individuals without SMI. This is consistent with differential access and treatment for an SMI population with co-morbid health conditions compared to the rest of the population. As states rethink systems of care with the implementation of the Affordable Care Act, the differential health burden for disadvantaged populations, such as those with SMI, needs to be considered. To the extent possible, disparities of access and need should be addressed with mechanisms such as patient-centered medical homes that provide for the integration of behavioral and medical treatment.

Reference: Chang CK, Hayes RD, Perera G, Broadbent MT, Fernandes AC, Lee WE, Hotopf M, Stewart, (2011) 'Life expectancy at birth for people with serious mental illness and other major disorders from a secondary mental health care case register in London'. R.PLoS One; 6(5).

Learning Areas:

Biostatistics, economics
Public health administration or related administration

Learning Objectives:
Evaluate the government's cost burden associated with medical co-morbidities for persons with Serious Mental Illness (SMI)in a Medicaid population Evaluate the differential burden of chronic disease among persons with SMI and persons without SMI and disparities by race, age and gender

Keyword(s): Cost Issues, Adult and Child Mental Health

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I am a health economist working at the Department of Mental Health and Addiction services. I have performed multiple economic evaluations for social and health interventions. I am currently working with DMHAS to develop care systems that will integrate behavioral and medical health services to overcome the unique challenges in increasing health care access and well being in a seriously mentally ill population.
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.

Back to: 4238.0: Health economics and costs