Health Disparities among Patients with Schizophrenia in an Integrated Healthcare System

Abstract: Background: The substantial disease burden of schizophrenia may be accompanied by disparities in diagnosis and treatment, such as with the use of second-generation antipsychotics (SGAs) compared to first-generation antipsychotics (FGAs). Using electronic health record (EHR) data from MedStar Health, an integrated delivery network in the Washington, DC metropolitan area, this study evaluated potential disparities in medication treatment in patients with schizophrenia. Methods: Eligible study patients were identified 01/01/2017-03/31/2022. The cohort consisted of adult patients with ≥2 outpatient diagnoses and/or ≥1 inpatient discharge diagnosis of schizophrenia. Demographics and medication use were analyzed in the 12-months following a patient’s first qualifying diagnosis (index). The study was approved by MedStar’s Institutional Review Board. Results: The final cohort of 10,026 patients had an average age of 46.0±16y; 56.3% were male. Most study patients were non-Hispanic Black (65.1%) and nearly half had Medicaid as their primary insurance (48.2%). Additional diagnoses of bipolar disorder (31.9%), anxiety (30.9%), drug abuse (29.1%), and depression (26.9%) were prevalent. Younger patients (aged 18-24y) had 2.40 times higher odds of using FGAs compared with those ≥65y (pShort Description: This retrospective study used electronic health records data from MedStar Health to identify patients with schizophrenia and their demographics, medication use, and healthcare resource utilization (HRU). The results highlight different clinical characteristics, antipsychotic utilization, and HRU by age group, race, and insurance type, identifying potential disparities in care among these patients.Name of Sponsoring Organization(s): Janssen Scientific Affairs, LLC.