Haloperidol is associated with Lower Hospital Readmission Rates for Psychoses Patients at Thorek Memorial Hospital based on Real World Evidence Study of Medicare Claims Data

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In Haloperidol, Psychoses

By: Sara Riascos  Apr. 05, 2022

Background:

Psychoses is frequently associated with hospital readmission. Readmission is a hospital quality measure that reflects dimensions of quality of inpatient care and also impacts overall programs by payors such as CMS’s Star Rating Program, HRRP and Value-Based Purchasing. Haloperidol is an antipsychotic used to treat certain mental/mood disorders (such as schizophrenia, schizoaffective disorders). Studies have shown that Haloperidol is more effective when treating Psychosis than a placebo and other depot antipsychotic agents.

Dexur’s analysis of Real-World Evidence based on Medicare Claims data showed that the use of Haloperidol within 7 days of hospitalization was associated with lower hospital readmission rates for Psychoses Patients at Thorek Memorial Hospital in Chicago, Illinois. Reduction in readmission rates helps hospitals improve their outcomes for various cost and quality programs. Dexur is an approved entity to perform Medicare claims data analysis, which it uses to perform quality outcomes analysis. Dexur has published several papers with Harvard Medical School on quality outcomes related topics. Dexur’s analysis of Drugs and their impact on quality outcomes, such as readmissions and mortality, are used by Hospitals, IDNs, and ACOs to implement best practices and manage Real World Evidence based risk factors.

Methods:

We conducted a retrospective study using Dexur’s analysis of Real-World Evidence from Medicare Claims data, for hospitalizations at Thorek Memorial Hospital between January 2017 to September 2019. Our methodology criteria was as follows:

1. Inclusion Criteria: Selected Medical Hospitalizations with Primary Diagnosis with Psychoses related codes (Listed in table below)
2. Stratified Selected population into cohorts
   1. Psychoses patients dispensed Haloperidol within 7 Days of Hospitalization using Part D drugs claims database
   2. Psychoses patients not dispense with Haloperidol within 7 Days of Hospitalization
3. 30 Day readmission rates were analyzed for both population cohorts

Results:

Overall, Haloperidol was associated with lower hospital readmission rates for all Primary ICD/DRG Diagnosis Codes examined at Thorek Memorial Hospital. For patients whose primary DRG Diagnosis was “Psychoses”(885) and when Haloperidol was used within 7 days of hospitalization, the readmission rate was 35.43% compared to the cohort where Haloperidol was not used, whose readmission rate was 41.05%. The readmission odds ratio for these cohorts was 0.79. The use of Haloperidol was associated with a 21% lower readmission rate when used within 7 days of hospitalization. The full list of studied ICD/DRG codes, readmission rates, odds ratios, confidence intervals, and percentage reduction in readmission with Haloperidol at Thorek Memorial Hospital is shown below.

Primary ICD/DRG Diagnosis Code	Primary ICD/DRG Diagnosis Code Description	Total Hospitalizations without Haloperidol	Readmission Without Haloperidol	Readmission Rate without Haloperidol	Total Hospitalizations with Haloperidol	Readmission with Haloperidol	Readmission Rate with Haloperidol	Readmission Odds Ratio	Reduction in Readmission with Haloperidol (%)	Confidence Interval (-)	Confidence Intervals (+)
885	PSYCHOSES	1,486	610	41.05%	127	45	35.43%	0.79	21%	-8%	-4%
F259	Schizoaffective disorder, unspecified

Dexur also leveraged Medicare claims data to understand what percentage of patients hospitalized with Psychoses were not prescribed Haloperidol within 7 days of discharge.

ICD/DRG CODE	Hospital	Hospitalizations with Psychoses	% of Hospitalizations without Haloperidol
885	Thorek Memorial Hospital	1,531	97.06%
	Silver Lake Medical Center	5,366	At Least 99.81%
	Lakeside Behavioral Health System	3518	At Least 99.66%
F259	Thorek Memorial Hospital	544	97.98%
	Presence Saints Mary and Elizabeth Medical Center - Saint Mary	601	At least 98.17%
	Silver Lake Medical Center	530	97.92%

​Hospitalizations with Psychoses = Above Listed ICD/DRG Codes

If figures are shared with “At Least” - this implies that the drug utilization within 7 days post hospitalization is less than 11

Conclusions:

According to analysis of Real-World Evidence of Medicare Claims data, for hospitalizations between January January 2017 to September 2019, the use of Haloperidol within 7 days of hospitalization can lead to substantial reductions in hospital readmission rates of Psychoses patients at Thorek Memorial Hospital. This analysis shows that a significant number of Patients are not dispensed Haloperidol after Psychoses hospitalizations at Thorek Memorial Hospital or major US Hospitals.