Utilization of general and specialized cardiac care by people with schizophrenia.
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.
Faculty of Medicine, University of Calgary, 3280 Hospital Dr., N.W., Ground Floor, Room GE61, Calgary, Alberta T2N 4Z6, Canada. lbresee@ucalgary.ca
Lauren C
LC
Bresee
Sumit R
SR
Majumdar
Scott B
SB
Patten
Jeffrey A
JA
Johnson
D000328:Adult; D000416:Alberta / Q000453:epidemiology; D016507:Cardiology Service, Hospital / Q000706:statistics & numerical data*; D003324:Coronary Artery Disease / Q000453:epidemiology* / Q000628:therapy; D019992:Databases as Topic; D003920:Diabetes Mellitus / Q000453:epidemiology; D004636:Emergency Service, Hospital / Q000706:statistics & numerical data*; D004812:Epidemiologic Methods; D005194:Family Practice; D005260:Female; D006297:Health Services Accessibility / Q000706:statistics & numerical data*; D006760:Hospitalization / Q000706:statistics & numerical data; D006801:Humans; D008297:Male; D008875:Middle Aged; D012559:Schizophrenia / Q000453:epidemiology*; D055815:Young Adult