Multimorbidity clusters and associated health care cost among patients attending psychiatric clinics in Odisha, India
Introduction: There is a dearth of data on common multimorbidity clusters and the healthcare costs for individuals with mental health disorders. This study aimed to identify clinically meaningful physical-mental multimorbidity clusters, frequently occurring clusters of conditions, and healthcare uti...
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| Format: | Article |
| Language: | English |
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Wolters Kluwer Medknow Publications
2023-07-01
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| Series: | Indian Journal of Psychiatry |
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| Online Access: | https://journals.lww.com/10.4103/indianjpsychiatry.indianjpsychiatry_463_22 |
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| author | Priti Gupta Solveig A. Cunningham Mohammed K. Ali Sailesh Mohan Pranab Mahapatra Sanghamitra C. Pati |
| author_facet | Priti Gupta Solveig A. Cunningham Mohammed K. Ali Sailesh Mohan Pranab Mahapatra Sanghamitra C. Pati |
| author_sort | Priti Gupta |
| collection | DOAJ |
| description | Introduction:
There is a dearth of data on common multimorbidity clusters and the healthcare costs for individuals with mental health disorders. This study aimed to identify clinically meaningful physical-mental multimorbidity clusters, frequently occurring clusters of conditions, and healthcare utilization patterns and expenditure among patients attending a psychiatric outpatient clinic.
Materials and Methods:
Data were collected in the psychiatric outpatient department among patients aged 18 years and above in February-July 2019 (n = 500); follow-up data on non-communicable disease incidence were collected after 18 months. For analysis, morbidity clusters were defined using two approaches: 1) agglomerative hierarchical clustering method to identify clusters of diseases; and 2) non-hierarchical cluster k mean analysis to identify clusters of patients. Self-reported healthcare costs in these clusters were also calculated.
Result:
Two disease clusters were identified: using the 1st approach were; 1) hypertension, diabetes, and mood disorder; 2) Neurotic, stress-related, and somatoform disorders, and acid peptic disease. Three clusters of patients identified using the 2nd approach were identified: 1) those with mood disorders and cardiometabolic, musculoskeletal, and thyroid diseases; 2) those with neurotic, substance use, and organic mental disorders, cancer, and epilepsy; and 3) those with Schizophrenia. Patients in Cluster 1 were taking more than six medicines and had more hospital visits. Within 18 months, 41 participants developed either one or two chronic conditions, most commonly diabetes, hypertension, or thyroid disease.
Conclusion:
Cardiometabolic diseases are most commonly clustered with mood disorders. There is a need for blood pressure and sugar measurement in psychiatric clinics and mood disorder screening in cardiac, endocrinology, and primary care clinics. |
| format | Article |
| id | doaj-art-abc36b82b356447e8550652dcded51dd |
| institution | Kabale University |
| issn | 0019-5545 1998-3794 |
| language | English |
| publishDate | 2023-07-01 |
| publisher | Wolters Kluwer Medknow Publications |
| record_format | Article |
| series | Indian Journal of Psychiatry |
| spelling | doaj-art-abc36b82b356447e8550652dcded51dd2025-02-07T11:21:37ZengWolters Kluwer Medknow PublicationsIndian Journal of Psychiatry0019-55451998-37942023-07-0165773674110.4103/indianjpsychiatry.indianjpsychiatry_463_22Multimorbidity clusters and associated health care cost among patients attending psychiatric clinics in Odisha, IndiaPriti GuptaSolveig A. CunninghamMohammed K. AliSailesh MohanPranab MahapatraSanghamitra C. PatiIntroduction: There is a dearth of data on common multimorbidity clusters and the healthcare costs for individuals with mental health disorders. This study aimed to identify clinically meaningful physical-mental multimorbidity clusters, frequently occurring clusters of conditions, and healthcare utilization patterns and expenditure among patients attending a psychiatric outpatient clinic. Materials and Methods: Data were collected in the psychiatric outpatient department among patients aged 18 years and above in February-July 2019 (n = 500); follow-up data on non-communicable disease incidence were collected after 18 months. For analysis, morbidity clusters were defined using two approaches: 1) agglomerative hierarchical clustering method to identify clusters of diseases; and 2) non-hierarchical cluster k mean analysis to identify clusters of patients. Self-reported healthcare costs in these clusters were also calculated. Result: Two disease clusters were identified: using the 1st approach were; 1) hypertension, diabetes, and mood disorder; 2) Neurotic, stress-related, and somatoform disorders, and acid peptic disease. Three clusters of patients identified using the 2nd approach were identified: 1) those with mood disorders and cardiometabolic, musculoskeletal, and thyroid diseases; 2) those with neurotic, substance use, and organic mental disorders, cancer, and epilepsy; and 3) those with Schizophrenia. Patients in Cluster 1 were taking more than six medicines and had more hospital visits. Within 18 months, 41 participants developed either one or two chronic conditions, most commonly diabetes, hypertension, or thyroid disease. Conclusion: Cardiometabolic diseases are most commonly clustered with mood disorders. There is a need for blood pressure and sugar measurement in psychiatric clinics and mood disorder screening in cardiac, endocrinology, and primary care clinics.https://journals.lww.com/10.4103/indianjpsychiatry.indianjpsychiatry_463_22clusterhealthcare expenditurepatternpsychiatric multimorbiditypsychiatric-somatic |
| spellingShingle | Priti Gupta Solveig A. Cunningham Mohammed K. Ali Sailesh Mohan Pranab Mahapatra Sanghamitra C. Pati Multimorbidity clusters and associated health care cost among patients attending psychiatric clinics in Odisha, India Indian Journal of Psychiatry cluster healthcare expenditure pattern psychiatric multimorbidity psychiatric-somatic |
| title | Multimorbidity clusters and associated health care cost among patients attending psychiatric clinics in Odisha, India |
| title_full | Multimorbidity clusters and associated health care cost among patients attending psychiatric clinics in Odisha, India |
| title_fullStr | Multimorbidity clusters and associated health care cost among patients attending psychiatric clinics in Odisha, India |
| title_full_unstemmed | Multimorbidity clusters and associated health care cost among patients attending psychiatric clinics in Odisha, India |
| title_short | Multimorbidity clusters and associated health care cost among patients attending psychiatric clinics in Odisha, India |
| title_sort | multimorbidity clusters and associated health care cost among patients attending psychiatric clinics in odisha india |
| topic | cluster healthcare expenditure pattern psychiatric multimorbidity psychiatric-somatic |
| url | https://journals.lww.com/10.4103/indianjpsychiatry.indianjpsychiatry_463_22 |
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