MENTAL HEALTH CARE OECD HCQI Expert meeting 17 th of May, 2013 Rie Fujisawa
Mental health indicators Any hospital readmissions for patients with schizophrenia Same hospital readmissions for patients with schizophrenia Any hospital readmissions among patients with schizophrenia Same hospital readmissions among patients with schizophrenia Any hospital readmissions for patients with bipolar disorder Same hospital readmissions for patients with bipolar disorder Any hospital readmissions among patients with bipolar disorder Same hospital readmissions among patients with bipolar disorder Inpatient death from suicide among patients admitted at the hospital for a mental disorder In-patient death from suicide among patients admitted at the hospital for schizophrenia or bipolar disorder Death from suicide among patients discharged with a mental disorder Death from suicide among patients discharged with schizophrenia or bipolar disorder Excess mortality from schizophrenia Excess mortality from bipolar disorder 2
Data submission Data submitted by 16 OECD and 1 non-oecd countries (BEL, CAN, CZE, FIN, HUN, ISR, ITA, KOR, LUX, NZL, PRT, SVK, ESP, SWE, CHE, GBR and LVA). Data are not available in AUT, FRA, GRC, ISL, JPN, NLD, POL and TUR. Validating data for CHL, IRL, NOR and SVN. Waiting for data from AUS, DEU and USA. No news from DNK, EST and MEX. 3
Countries MENTAL HEALTH CARE AVERSCHA AVERSCHS ADMRSCHA ADMRSCHS AVERBIPA AVERBIPS ADMRBIPA ADMRBIPS SUICMENT SUICSEME MORTSUMD MORTSUMD EXCESCHI EXCEBIPO Australia Austria............................ Belgium.. 2010.. 2010.. 2010.. 2010 2010 2010........ Canada................ 2011 2011........ Chile 2010 2010 2010 2010 2010 2010 2010 2010 2010 2010 2010 2010 Czech Republic 2011 2011 2011 2011 2011 2011 2011 2011 2011 2011 2011 2011.... Denmark Estonia Finland 2011 2011.... 2011 2011.... 2011 2011 2011 2011 2011 2011 France............................ Germany Greece............................ Hungary 2012 2012 2012 2012 2012 2012 2012 2012 2012 2012........ Iceland............................ Ireland Israel 2012 2012 2012 2012 2012 2012 2012 2012 2009 2009 2009 2009 2009 2009 Italy 2011 2011 2011 2011 2011 2011 2011 2011 2011 2011........ Japan............................ Korea 2011 2011 2011 2011 2011 2011 2011 2011........ 2011 2011 Luxembourg........ 2011 2011................ Mexico Netherlands............................ New Zealand 2011 2011 2011 2011 2011 2011 2011 2011 2010 2010 2010 2010 Norway 2011 2011 2011 2011 2011 2011 2011 2011 2011 2011........ Poland............................ Portugal 2011 2011 2011 2011 2011 2011 2011 2011............ Slovak Republic 2011 2011.... 2011 2011.... 2011 2011........ Slovenia................ 2011 2011 2011 2011.... Spain.. 2011.. 2011.. 2011.. 2011 2011 2011........ Sweden 2011 2011 2011 2011 2011 2011 2011 2011.... 2011 2011 2011 2011 Switzerland 2010 2010 2010 2010 2010 2010 2010 2010 2010 2010........ Turkey United Kingdom 2011 2011 2011 2011 2011 2011 2011 2011 2011 2011 2011 2011.... USA Singapore............................ Brazil Latvia.................... 2011 2011 2011.. 4
Proposals for HAG 2013 Hospital re-admissions within 30 days Mortality 5
Same and any hospital re-admissions within 30 days for patients discharged with schizophrenia, 2006 and 2011 (preliminary) Portugal Spain Korea Israel Sweden New Zealand Italy United Kingdom Hungary Belgium Switzerland Czech Republic Finland Slovak Republic 0.42 0.35 0.33 0.30 0.31 0.22 0.15 0.16 0.13 0.09 0.08 1.58 Same hospital (2011) Any hospital (2011) Any hospital (2006) -1.0 0.0 1.0 2.0 3.0 4.0 Per patient Notes: 2011 data on Belgium and Switzerland refer to 2010. 2006 data refer to 2007 for Korea and the United Kingdom, 2008 for Sweden and 2009 for the Czech Republic and Portugal. 6
Any hospital re-admissions within 30 days for patients discharged with schizophrenia by gender, 2011 (preliminary) Portugal 1.39 Korea 0.40 Israel 0.34 New Zealand 0.29 Italy 0.31 Sweden United Kingdom Switzerland 0.22 0.13 0.39 Female Male Hungary 0.15 Czech Republic 0.12 Finland 0.09 Slovak Republic 0.08-0.5 0.0 0.5 1.0 1.5 2.0 2.5 Notes: Data on Switzerland refer to 2010. Per patient 7
Same and any hospital re-admissions within 30 days among patients discharged with schizophrenia, 2006 and 2011 (preliminary) Israel 22.0 Korea 22.7 Sweden 17.1 New Zealand 19.0 Belgium Spain Italy 17.5 United Kingdom 13.5 Hungary Czech Republic Switzerland Portugal 1.7 9.4 10.8 10.4 Same hospital (2011) Any hospita (2011) Any hospital (2006) 0 5 10 15 20 25 30 % of patients Notes: 2011 data on Belgium and Switzerland refer to 2010. 2006 data refer to 2007 for Korea, 2008 for Sweden and the United Kingdom and 2009 for the Czech Republic. 8
% of Patients with readmissions within 30 days Any hospital readmissions within 30 days per patient and % of patients with any hospital readmissions within 30 days, schizophrenia, 2011 (preliminary) 25 20 15 KOR ISR NZL SWE ITA GBR 10 HUN CZE CHE 5 PRT 0 0.0 0.2 0.4 0.6 0.8 1.0 1.2 1.4 1.6 1.8 Number of readmissions within 30 days per patient Notes: Data on Switzerland refer to 2010. 9
Same and any hospital re-admissions within 30 days for patients discharged with bipolar disorder, 2006 and 2011 (preliminary) Portugal Spain Sweden Israel United Kingdom New Zealand Korea Italy Belgium Switzerland Czech Republic Hungary Finland Slovak Republic 0.29 0.30 0.24 0.26 0.19 0.26 0.15 0.12 0.09 0.09 0.07 2.14 Same hospital (2011) Any hospital (2011) Any hospital (2006) -0.5 0.0 0.5 1.0 1.5 2.0 2.5 3.0 3.5 Per patient Notes: 2011 data on Belgium and Switzerland refer to 2010. 2006 data refer to 2007 for Korea and the United Kingdom, 2008 for Sweden and 2009 for the Czech Republic and Portugal. 10
Same and any hospital re-admissions within 30 days among patients discharged with bipolar disorder, 2006 and 2011 (preliminary) Israel 19.9 Sweden 17.8 New Zealand 17.8 Belgium Spain United Kingdom 14.1 Korea 12.6 Italy 16.0 Czech Republic Switzerland Hungary 7.2 9.6 10.4 Same hospital (2011) Any hospita (2011) Portugal 1.0 Any hospital (2006) 0 5 10 15 20 25 30 % of patients Notes: 2011 data on Belgium and Switzerland refer to 2010. 2006 data refer to 2007 for Korea, 2008 for Sweden and the United Kingdom and 2009 for the Czech Republic. 11
% of Patients with readmissions within 30 days Any hospital readmissions within 30 days per patient and % of patients with any hospital readmissions within 30 days, bipolar disorder, 2011 (preliminary) 25 20 15 10 5 ISR NZL SWE ITA GBR KOR CZE CHE HUN PRT 0 0.0 0.5 1.0 1.5 2.0 2.5 Number of readmissions within 30 days per patient Notes: Data on Switzerland refer to 2010. 12
Proposals for HAG 2013 Hospital re-admissions within 30 days Same hospital readmissions for patients with schizophrenia, 2006 and 2011 Same hospital readmissions among patients with schizophrenia, 2006 and 2011 Same hospital readmissions for patients with bipolar disorder, 2006 and 2011 Same hospital readmissions among patients with bipolar disorder, 2006 and 2011 13
Mortality: In-patient death from suicide among patients admitted at the hospital for a mental disorder, 2006 and 2011 (preliminary) Finland 0.07 Canada 0.06 Israel 0.06 United Kingdom 0.05 Slovak Republic 0.05 New Zealand 0.03 Hungary 0.03 Switzerland 0.02 Male (2011) Spain Belgium Czech Republic Italy 0.00 0.00 0.02 0.02 Female (2011) Total (2011) Total (2006) -0.05 0.00 0.05 0.10 0.15 Age -sexstandardised rates (%) Notes: 2011 data refer to 2010 for Belgium, New Zealand and Switzerland and 2009 for Israel, and 2006 data refer to 2008 for the United Kingdom. 14
Mortality: In-patient death from suicide among patients admitted at the hospital for schizophrenia or bipolar disorder, 2006 and 2011 (preliminary) New Zealand United Kingdom Finland Slovak Republic Israel Canada Switzerland Spain Belgium Hungary Italy Czech Republic 0.09 0.08 0.06 0.05 0.04 0.04 0.04 0.02 0.02 0.01 0.00 0.00 Male (2011) Female (2011) Total (2011) Total (2006) -0.1 0.0 0.1 0.2 0.3 Age-sex standardised rates (%) Notes: 2011 data refer to 2010 for Belgium, New Zealand and Switzerland and 2009 for Israel, and 2006 data refer to 2008 for the United Kingdom. 15
In-patient deaths from suicide, schizophrenia or bipolar disorder (%) In-patient death from suicide among patients admitted at the hospital for a mental disorder, and schizophrenia or bipolar disorder, 2011 (preliminary) 0.06 0.05 0.04 CHE SVK ISR CAN 0.03 0.02 0.01 BEL ESP HUN CZE 0.00 ITA 0.00 0.01 0.02 0.03 0.04 0.05 0.06 In-patient deaths from suicide, mental disorders (%) Notes: Data refer to 2010 for Belgium, New Zealand and Switzerland and 2009 for Israel. 16
Mortality: Death from suicide among patients discharged with a mental disorder, 2006 and 2011 (preliminary) Sweden 0.33 Finland 0.26 Israel 0.24 New Zealand 0.20 Male (2011) Czech Republic United Kingdom 0.06 0.17 Female (2011) Total (2011) Total (2006) 0.0 0.1 0.2 0.3 0.4 0.5 0.6 Age -sex standardised rates (%) Notes: 2011 data refer to 2010 for New Zealand and 2009 for Israel, and 2006 data refer to 2008 for Sweden and the United Kingdom. 17
Mortality: Death from suicide among patients discharged with schizophrenia or bipolar disorder, 2006 and 2011 (preliminary) Sweden 0.37 Israel 0.27 New Zealand 0.23 Finland 0.18 Male (2011) Czech Republic United Kingdom 0.14 0.13 Female (2011) Total (2011) Total (2006) -0.1 0.0 0.1 0.2 0.3 0.4 0.5 0.6 0.7 Age-sex standardised rates (%) Notes: 2011 data refer to 2010 for New Zealand and 2009 for Israel, and 2006 data refer to 2008 for Sweden and the United Kingdom. 18
Deaths from suicide, schizophrenia or bipolar disorder (%) Mortality: Death from suicide among patients discharged with a mental disorder or schizophrenia or bipolar disorder, 2011 (preliminary) 0.4 SWE 0.3 0.2 NZL ISR FIN 0.1 GBR CZE 0.0 0.0 0.1 0.2 0.3 0.4 Deaths from suicide, mental disorders (%) Notes: Data refer to 2010 for New Zealand and 2009 for Israel. 19
Mortality: Excess mortality from schizophrenia, 2006 and 2011 (preliminary) Sweden 6.80 Finland 4.00 Israel Korea 3.30 3.10 Male (2011) Female (2011) Total (2011) Total (2006) 0 2 4 6 8 10 Ratio Notes: 2011 data refer to 2009 for Israel, and 2006 data refer to 2007 for Korea and 2008 for Sweden. 20
Mortality: Excess mortality from bipolar disorder, 2006 and 2011 (preliminary) Sweden 8.80 Israel 6.80 Finland 6.00 Male (2011) Female (2011) Korea 3.60 Total (2011) Total (2006) 0 2 4 6 8 10 12 Ratio Notes: 2011 data refer to 2009 for Israel, and 2006 data refer to 2007 for Korea and 2008 for Sweden. 21
Proposals for HAG 2013 Mortality Death from suicide among patients discharged with a mental disorder, 2006 and 2011 Death from suicide among patients discharged with schizophrenia or bipolar disorder, 2006 and 2011 Excess mortality from schizophrenia, 2006 and 2011 Excess mortality from bipolar disorder, 2006 and 2011 22