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Treatment prevalence and incidence of schizophrenia in Quebec using a population health services perspective: different algorithms, different estimates

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Abstract

Purpose

Using a population health services perspective, this article defines and assesses an efficient criteria-based algorithm to identify treatment prevalent and incident cases of schizophrenia. We refer here “treatment” prevalence and incidence since its evaluation depends on a patient receiving a health care service with a diagnosis of schizophrenia.

Methods

A population-based cohort study was conducted among all adults having a hospital discharge or a physician claim for schizophrenia in the public health plan databases between January 1996 and December 2006. Four algorithms to characterize patients with schizophrenia were defined. To identify treatment incident cases in 2006, we removed from the treatment prevalent pool patients with a previous record of schizophrenia between 1996 and 2006 (10-year clearance period). Using this 10-year period as reference, Kappa coefficients (KC) and positive predictive values (PPV) were calculated to determine the “optimal” length of clearance period to identify incident cases.

Results

The lifetime treatment prevalence and incidence of schizophrenia varied from 0.59 to 1.46% and from 42 to 94 per 100,000, respectively. When compared to the 10-year clearance period, the KC is excellent in a clearance period of 6–7 years. To achieve a PPV of 90%, a clearance period of 7–8 years would be necessary.

Conclusions

With an appropriate algorithm, treatment prevalence and incidence of schizophrenia can be conveniently estimated using administrative data. These estimates are a vital step toward appropriate planning of services for schizophrenia.

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Acknowledgments

This project was sponsored by AstraZeneca Canada Inc. through its Prends soin de toi program. None of the authors received salaries, consultation fees or any reimbursement from this company, nor held any shares in this organization. The principal investigator was supported by the Department of Family Medicine, Université de Sherbrooke; the Clinical Research Center, Sherbrooke University Hospital; and the Fonds de Recherche en Santé du Québec.

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Authors and Affiliations

  1. Department of Family Medicine, Faculty of Medicine, Université de Sherbrooke, 3001 12th Avenue North, Sherbrooke, QC, J1H 5N4, Canada

    Alain Vanasse

  2. PRIMUS Group, Clinical Research Center (CHUS), Sherbrooke, QC, Canada

    Alain Vanasse & Josiane Courteau

  3. Centre de recherche de la Division psychosociale, Institut Douglas, McGill University, Montreal, QC, Canada

    Marie-Josée Fleury

  4. URESP, Centre de recherche FRSQ du CHA universitaire de Québec, Quebec, QC, Canada

    Jean-Pierre Grégoire & Jocelyne Moisan

  5. Faculté de pharmacie, Université Laval, Quebec, QC, Canada

    Jean-Pierre Grégoire & Jocelyne Moisan

  6. Centre de recherche Fernand-Seguin, Hôpital Louis-H. Lafontaine, Montreal, QC, Canada

    Alain Lesage

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  1. Alain Vanasse
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  2. Josiane Courteau
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Correspondence to Alain Vanasse.

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Vanasse, A., Courteau, J., Fleury, MJ. et al. Treatment prevalence and incidence of schizophrenia in Quebec using a population health services perspective: different algorithms, different estimates. Soc Psychiatry Psychiatr Epidemiol 47, 533–543 (2012). https://doi.org/10.1007/s00127-011-0371-y

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  • DOI: https://doi.org/10.1007/s00127-011-0371-y

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