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Abstract

Objective:

Whether access to primary and specialist care has an impact on treatment for people with schizophrenia and comorbid cardiac disease is unclear. The objective of this study was to compare use of general health care and specialized cardiac care by people with schizophrenia and by the rest of the population.

Methods:

A population-based period-prevalence study was conducted and included adults (N=2,310,391) in Alberta, Canada, by using administrative databases. People with schizophrenia were identified based on billing codes; all others served as the comparator cohort. Multivariable logistic regression analyses were conducted to compare claims for general (general practitioner visits) health care, urgent and emergent (emergency department visits and hospitalizations) health services, and specialized cardiac (cardiologist visits, revascularization) care.

Results:

Individuals with schizophrenia (N=28,755) had a higher prevalence of coronary artery disease than those without schizophrenia (N=2,281,636) (20% versus 14%) and were more likely than those without schizophrenia to visit a general practitioner more than four times per year (76% versus 47%; adjusted odds ratio [AOR]=3.60, 95% confidence interval [CI]=3.49–3.71). In contrast, individuals with schizophrenia and coronary artery disease were less likely to visit a cardiologist (50% versus 59%; AOR=. 76, 95% CI=.72–.80) or undergo coronary revascularization (6% versus 12%; AOR=. 55, 95% CI=.49–.61).

Conclusions:

In this large population-based study, individuals with schizophrenia were less likely to visit cardiologists or undergo revascularization than were people without schizophrenia. Opportunities exist for better assessment and management of cardiovascular disease and risk factors among people with schizophrenia. (Psychiatric Services 63:237–242, 2012; doi: 10.1176/appi.ps.201000363)

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Table 1 Characteristics of people with and without schizophrenia who were eligible for Alberta (Canada) Health Care coverage, 1995–2006
Table 2 Encounters with the health care system among people with and without schizophrenia who were eligible for Alberta (Canada) Health Care coverage, 1995–2006
Table 3 Procedures and utilization of specialist care in individuals with established coronary artery disease or diabetes

Information & Authors

Information

Published In

Go to Psychiatric Services
Go to Psychiatric Services
Psychiatric Services
Pages: 237 - 242
PubMed: 22307876

History

Published online: 1 March 2012
Published in print: March 2012

Authors

Details

Lauren C. Bresee, Ph.D. [email protected]
Dr. Bresee is affiliated with the Faculty of Medicine, University of Calgary, 3280 Hospital Dr., N.W., Ground Floor, Room GE61, Calgary, Alberta T2N 4Z6, Canada (e-mail: [email protected]).
Sumit R. Majumdar, M.D., M.P.H.
Dr. Majumdar is with the Department of Medicine and Dr. Johnson is with the School of Public Health, both at the University of Alberta, Edmonton.
Scott B. Patten, M.D., Ph.D.
Dr. Patten is with the Departments of Psychiatry and Community Health Sciences, University of Calgary.
Jeffrey A. Johnson, Ph.D.
Dr. Majumdar is with the Department of Medicine and Dr. Johnson is with the School of Public Health, both at the University of Alberta, Edmonton.

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