Unforeseen inpatient mortality among veterans with schizophrenia

Laurel A. Copeland, John E. Zeber, Robert A. Rosenheck, Alexander L. Miller

Research output: Contribution to journalArticlepeer-review

27 Scopus citations

Abstract

Background: Patients with schizophrenia have co-occurring medical conditions, like other patients, but may lack the capacity to provide good self-care or to work with their providers to ensure appropriate medical treatment. We hypothesized that death among patients with schizophrenia occurs more frequently after minimal care of comorbid conditions. Methods: All patients who died in veterans affairs (VA) hospitals during FY02 were categorized as to type of death: unforeseen (age <80 years, 1-2 inpatient days past year), cancer, organ failure (heart, lungs, kidneys), frailty (dementias, hip fractures, dehydration, etc.), or other deaths. Logistic regression explored factors in unforeseen death. Results: During the year, 27,798 patients died in VA facilities; 3% had schizophrenia (n = 943). Roughly two-thirds of all deaths were from cancer or organ failure, 11% frailty, 9% other, and 8% met criteria for unforeseen death. Among patients with schizophrenia, however, 20% fell into the unforeseen death category. In an adjusted model, schizophrenia was associated with a 2-fold increased risk of unforeseen death compared with any other category (odds ratio = 2.4, 95% confidence interval 1.6-3.4). Unforeseen death was less likely among patients with substance abuse diagnoses in the year before death and more likely when patients had no outpatient medical care. Conclusions: VA patients with schizophrenia were more likely to die as inpatients with little previous-year care compared with other inpatient decedents without schizophrenia. Outreach efforts may be necessary to engage patients with schizophrenia in treatment of potentially life-threatening conditions.

Original languageEnglish (US)
Pages (from-to)110-116
Number of pages7
JournalMedical Care
Volume44
Issue number2
DOIs
StatePublished - Feb 1 2006

Keywords

  • Aging
  • Comorbidity
  • Health services
  • Mortality
  • Schizophrenia
  • Veterans

ASJC Scopus subject areas

  • Public Health, Environmental and Occupational Health

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