title: One-year post-hospital medical costs and relapse rates of bipolar disorder patients in Taiwan: a population-based study.
abstract: OBJECTIVE
  We examined a nationwide population-based dataset of patients with bipolar disorder (BD) hospitalized in Taiwan, with our analyses focusing on one-year medical costs and relapse rates.
  
  
  METHODS
  The data for this study, covering the years 2006 and 2007, were obtained from the Taiwan National Health Insurance (NHI) claims database. The study sample comprised BD patients who were discharged from hospitals between January 1 and December 31, 2006. Annual medical costs and relapse rates were described; the Kaplan-Meier method and the generalized linear models were carried out to examine the risk factors associated with cases of relapse.
  
  
  RESULTS
  The annual medical costs associated with relapses among the study sample were found to be approximately 7.6 times the average per-capita NHI expenditure in Taiwan in 2006 (US$4,354 versus US$574), with a one-year relapse rate of 55%. Those patients between 20 and 60 years old with a medication possession ratio of <80 and with depressive episodes during the recruitment period were identified as being at risk of relapse.
  
  
  CONCLUSIONS
  Bipolar disorder, which is a very costly disease, is associated with both poor medication adherence rates and frequent recurrences. Targeting drug adherence issues during maintenance treatment may well provide a valuable opportunity to reduce the risk of such recurrences.
authors.affiliation: School of Health Care Administration, Gynecology Research Center, Taipei Medical University, Taipei, Taiwan.
authors.forename: Chao-Hsiun
authors.initials: CH
authors.lastname: Tang
authors.forename: Ming H
authors.initials: MH
authors.lastname: Hsieh
authors.forename: Sheng-Tzu
authors.initials: ST
authors.lastname: Hung
authors.forename: I Hui
authors.initials: IH
authors.lastname: Lee
authors.forename: Yung-Jung
authors.initials: YJ
authors.lastname: Lin
authors.forename: Yen Kuang
authors.initials: YK
authors.lastname: Yang
mesh_terms: D000328:Adult; D001714:Bipolar Disorder / Q000191:economics* / Q000453:epidemiology / Q000517:prevention & control; D005260:Female; D006801:Humans; D053208:Kaplan-Meier Estimate; D016014:Linear Models; D008297:Male; D008875:Middle Aged; D010351:Patient Discharge; D012008:Recurrence; D012494:Sampling Studies; D013624:Taiwan / Q000453:epidemiology; D013997:Time Factors