{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,30]],"date-time":"2026-07-30T17:50:42Z","timestamp":1785433842207,"version":"3.56.0"},"reference-count":36,"publisher":"Royal College of Psychiatrists","issue":"6","license":[{"start":{"date-parts":[[2025,10,13]],"date-time":"2025-10-13T00:00:00Z","timestamp":1760313600000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["cambridge.org"],"crossmark-restriction":true},"short-container-title":["BJPsych open"],"published-print":{"date-parts":[[2025,11]]},"abstract":"<jats:sec id=\"S2056472425108685_as1\">\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Significant changes in Taiwan\u2019s psychiatric services over recent decades include expansion of community-based clinics and implementation of the Schizophrenia Pay-for-Performance programme.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"S2056472425108685_as2\">\n                    <jats:title>Aims<\/jats:title>\n                    <jats:p>This study aimed to assess the trend of the quality of healthcare for individuals with schizophrenia, using various indicators of the treatment process and outcomes between 2010 and 2019.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"S2056472425108685_as3\">\n                    <jats:title>Method<\/jats:title>\n                    <jats:p>Individuals with schizophrenia were identified using Taiwan\u2019s National Health Insurance claims database. The quality of healthcare for individuals with schizophrenia was assessed using treatment process and outcome indicators, including antipsychotic types, medication adherence, daily dose for antipsychotics and concurrent use of other psychotropic agents. Outcome indicators included all-cause mortality, suicide deaths, psychiatric hospitalisation, emergency department visits and employment status.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"S2056472425108685_as4\">\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Antipsychotic medication usage has shifted towards second-generation antipsychotics (SGAs) and long-acting injectable antipsychotics (LAIs), with declines in first-generation antipsychotics. The percentage of medication adherence declined, while that of individuals with an adequate daily dose increased. Concurrently, anticholinergic and benzodiazepine use decreased while antidepressant and mood stabiliser use increased. Outcome indicators showed no significant change in all-cause mortality or suicide rates over time, but there were reductions in psychiatric hospitalisations and emergency department visits. Employment rates increased overall, particularly in urban areas.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"S2056472425108685_as5\">\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>The quality of healthcare for individuals with schizophrenia, as measured by treatment process and outcome indicators, improved alongside changes in Taiwan\u2019s psychiatric services; however, causality cannot be inferred from our findings. Future research should evaluate the effectiveness of psychiatric service policies and continuously monitor healthcare quality to further enhance the lives of individuals with schizophrenia.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1192\/bjo.2025.10868","type":"journal-article","created":{"date-parts":[[2025,10,13]],"date-time":"2025-10-13T08:15:16Z","timestamp":1760343316000},"update-policy":"https:\/\/doi.org\/10.1017\/policypage","source":"Crossref","is-referenced-by-count":1,"title":["Healthcare for individuals with schizophrenia in Taiwan: 10-year national trend analysis"],"prefix":"10.1192","volume":"11","author":[{"given":"Shen-Yu","family":"Tsai","sequence":"first","affiliation":[{"name":"National Taiwan University Hospital"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ming-Shiang","family":"Wu","sequence":"additional","affiliation":[{"name":"National Health Research Institutes"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shi-Heng","family":"Wang","sequence":"additional","affiliation":[{"name":"China Medical University"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shih-Cheng","family":"Liao","sequence":"additional","affiliation":[{"name":"National Taiwan University"},{"name":"National Taiwan University Hospital"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wei J","family":"Chen","sequence":"additional","affiliation":[{"name":"National Health Research Institutes"},{"name":"National Taiwan University"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2762-7295","authenticated-orcid":false,"given":"Chi-Shin","family":"Wu","sequence":"additional","affiliation":[{"id":[{"id":"https:\/\/ror.org\/03nteze27","id-type":"ROR","asserted-by":"publisher"}],"name":"National Taiwan University Hospital"},{"id":[{"id":"https:\/\/ror.org\/02r6fpx29","id-type":"ROR","asserted-by":"publisher"}],"name":"National Health Research Institutes"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"170","published-online":{"date-parts":[[2025,10,13]]},"reference":[{"key":"S2056472425108685_ref29","doi-asserted-by":"publisher","DOI":"10.1186\/s40345-018-0140-x"},{"key":"S2056472425108685_ref1","doi-asserted-by":"publisher","DOI":"10.1093\/schbul\/sbs130"},{"key":"S2056472425108685_ref12","doi-asserted-by":"publisher","DOI":"10.1111\/1475-6773.13174"},{"key":"S2056472425108685_ref27","doi-asserted-by":"publisher","DOI":"10.1176\/appi.ps.201300066"},{"key":"S2056472425108685_ref5","doi-asserted-by":"publisher","DOI":"10.1002\/wps.20060"},{"key":"S2056472425108685_ref6","doi-asserted-by":"publisher","DOI":"10.1176\/appi.ajp.2018.17091001"},{"key":"S2056472425108685_ref11","doi-asserted-by":"publisher","DOI":"10.1016\/j.jfma.2022.02.011"},{"key":"S2056472425108685_ref24","doi-asserted-by":"publisher","DOI":"10.1038\/s41380-023-02154-4"},{"key":"S2056472425108685_ref13","doi-asserted-by":"publisher","DOI":"10.1016\/j.jad.2019.09.044"},{"key":"S2056472425108685_ref36","volume-title":"Agricultural and Rural Transformations in Asian Development: Past Trends and Future Challenges","author":"Vos","year":"2018"},{"key":"S2056472425108685_ref19","doi-asserted-by":"publisher","DOI":"10.1001\/jamainternmed.2016.5057"},{"key":"S2056472425108685_ref34","doi-asserted-by":"publisher","DOI":"10.1111\/pcn.13607"},{"key":"S2056472425108685_ref4","doi-asserted-by":"publisher","DOI":"10.1192\/bjp.171.6.502"},{"key":"S2056472425108685_ref14","doi-asserted-by":"publisher","DOI":"10.1001\/jama.1988.03410120089033"},{"key":"S2056472425108685_ref25","doi-asserted-by":"publisher","DOI":"10.1001\/archgenpsychiatry.2011.1532"},{"key":"S2056472425108685_ref33","volume-title":"Vocational Rehabilitation Case Management Services","year":"2025"},{"key":"S2056472425108685_ref16","doi-asserted-by":"publisher","DOI":"10.1007\/s40268-017-0216-6"},{"key":"S2056472425108685_ref18","first-page":"1","article-title":"Incorporating development stratification of Taiwan townships into sampling design of large scale health interview survey","volume":"4","author":"Liu","year":"2006","journal-title":"J Health Manage"},{"key":"S2056472425108685_ref2","doi-asserted-by":"publisher","DOI":"10.1007\/s00127-004-0762-4"},{"key":"S2056472425108685_ref32","unstructured":"32 National Statistics Republic of China (Taiwan). 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Published by Cambridge University Press on behalf of Royal College of Psychiatrists","name":"copyright","label":"Copyright","group":{"name":"copyright_and_licensing","label":"Copyright and Licensing"}},{"value":"This is an Open Access article, distributed under the terms of the Creative Commons Attribution licence (https:\/\/creativecommons.org\/licenses\/by\/4.0\/), which permits unrestricted re-use, distribution and reproduction, provided the original article is properly cited.","name":"license","label":"License","group":{"name":"copyright_and_licensing","label":"Copyright and Licensing"}},{"value":"This content has been made available to all.","name":"free","label":"Free to read"}],"article-number":"e244"}}