title: Medical costs and vasculometabolic comorbidities among patients with bipolar disorder in Taiwan - a population-based and matched-control study.
abstract: BACKGROUND
  Bipolar disorder (BD) is a costly disease with a high rate of vasculometabolic comorbidities. The aims of this study were to explore the 1-year treatment cost, including total medical and non-psychiatric services, and the prevalence of vasculometabolic comorbidities in individuals with BD.
  
  
  METHODS
  A nationwide population-based dataset, covering the years 2006 and 2007, was obtained from the Taiwan National Health Insurance claims database. The study sample comprised patients discharged from hospitals between 1 January 2006 and 31 December 2007. Annual non-psychiatric and total medical costs and vasculometabolic comorbidities were examined. Generalized linear models were used to examine the medical costs, and conditional logistic regression analyses were carried out to test the prevalence of vasculometabolic comorbidities in people with BD and to compare this with that found in matched controls.
  
  
  RESULTS
  The total medical cost was 11-fold higher (New Taiwan [NT] $227,040 vs. NT$20,461), and the non-psychiatric medical cost was 1.7-fold higher (NT$33,173 vs. NT$19,406) with regard to the individuals with BD vs. the matched controls. The prevalence of vasculometabolic comorbidities was significantly higher in the individuals with BD than in the controls (ratio ranging from 1.86 to 4.06).
  
  
  CONCLUSIONS
  Both the non-psychiatric healthcare utilization and the prevalence of vasculometabolic comorbidities are higher with regard to individuals with BD vs. their matched controls. Therefore, treatment of BD should integrate medical and psychiatric care to decrease the impact of medical comorbidities, which may also decrease the overall medical cost.
authors.affiliation: Institute of Medicine, Chung Shan Medical University, Taichung, Taiwan.
authors.forename: Ming Hong
authors.initials: MH
authors.lastname: Hsieh
authors.forename: Chao-Hsiun
authors.initials: CH
authors.lastname: Tang
authors.forename: Ming H
authors.initials: MH
authors.lastname: Hsieh
authors.forename: I Hui
authors.initials: IH
authors.lastname: Lee
authors.forename: Te Jen
authors.initials: TJ
authors.lastname: Lai
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* / Q000628:therapy; D016022:Case-Control Studies; D015897:Comorbidity; D003365:Costs and Cost Analysis; D003920:Diabetes Mellitus / Q000453:epidemiology; D005260:Female; D017048:Health Care Costs; D006331:Heart Diseases / Q000453:epidemiology; D006801:Humans; D006973:Hypertension / Q000453:epidemiology; D052439:Lipid Metabolism Disorders / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D015995:Prevalence; D012189:Retrospective Studies; D012959:Socioeconomic Factors; D020521:Stroke / Q000453:epidemiology; D013624:Taiwan / Q000453:epidemiology; D014507:Urbanization; D055815:Young Adult