Pharmacy and Therapeutics - January 2008 - (Page 23) Impact of Bipolar Disorder on the Family continued from page 16 Table 1 Summary of Demographics as a Function of Family Type Families Containing a Member with BPD One Individual with BPD No. of families Household size (%) Single households Family with 2 members Family with 3+ members 41,704 28 24 48 Two Individuals with BPD 1,623 Three or More Individuals with BPD 121 Total Families Containing a Member with BPD 43,448 27 24 49 48 (12.3) 16.6 42.7 9.8 37.3 76.5 26.0 24.5 49.5 26.5 52.9 14.1 57.0 79.3 28.4 20.2 50.5 10.7 24.4 6.4 23.0 60.6 27.1 22.4 50.1 939 18.6 29.5 36.7 11.2 4.1 12.3 24.8 30.6 37.2 5.0 2.5 13.6 16.7 28.9 38.2 12.6 3.6 10.2 Matched Families 122,769 23 25 52 47 (15.4) 0.0 0.3 0.2 0.1 N/A 27.3 22.5 49.8 761 16.6 28.8 38.7 13.1 2.8 6.8 19 81 100 Mean age (SD) of primary insured (years) BPD therapy (%) Lithium Valproate Conventional Atypical Other Insurance type (%)* Indemnity HMO or capitated plan PPO/POS 10.4 23.6 6.3 22.3 59.9 27.1 22.4 50.1 Average length of insurance coverage (days) Region (%) Northeast North central South West Unknown Mean No. of MDCs 16.6 28.8 38.3 12.8 3.6 10.1 * Missing values contribute the unclassified insurance plan types. BPD = bipolar disorder; HMO = health maintenance organization; MDC = Major Diagnostic Category; N/A = not applicable; PPO = preferred provider organization; POS = point-of-service; SD = standard deviation. families. The category of “Mental Diseases and Disorders” was notably higher for these families, because the control families had been selected on the basis of a lack of claims with diagnoses for serious mental illnesses. Bipolar families (including the member with bipolar disorder) also used significantly more medical services than the matched families. The bipolar families made more outpatient physician visits, had more inpatient hospital stays, and bought more prescription medications (Table 3). Almost 90% of their total health care usage went toward treating conditions other than bipolar disorder. Health care costs followed similar trends. Total annual mean health care costs were 239% higher for bipolar families than for matched controls, primarily because of the difference in mean annual inpatient expenses and prescription costs (see Table 3). Only 13% of total health care expenditures went toward the treatment of bipolar disorder. Total health care costs per family depended on which fam- ily member had bipolar disorder. For families with only one member with bipolar disorder, costs were higher if a child rather than a parent had the diagnosis ($5,791 vs. $4,476, respectively) (Table 4). The health care costs for families with two members with bipolar disorder (child and parent) were higher than for families with only one member with the diagnosis. In terms of between-group differences, the costs for families having both a parent and child with bipolar disorder were nearly six-fold higher than the costs for control families with children. Among the individuals with bipolar disorder, children had the lowest per-member costs ($2,432); adults (spouse or employee) had the highest per-member costs (see Table 4). Among the bipolar families, health care costs for a child or a sibling of an individual with bipolar disorder were more than 60% lower than those for an adult family member (i.e., a spouse, parent, or mother of an individual with bipolar disorder). Mothers of children with bipolar disorder had the largest differen- Vol. 33 No. 1 • January 2008 • P&T® 23
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