Kalpesh Patel, MD, Pavan Patel, MD, Grace H. Yang, MD, Siddharth Verma, MD, JD
Rutgers New Jersey Medical School, Newark, NJ
Introduction: Crohn's disease (CD) and ulcerative colitis (UC) are inflammatory bowel diseases (IBDs) with an increasing prevalence in developed and developing countries. IBD ranks as 1 of the top 5 most expensive gastrointestinal disorders and costs are estimated to exceed $6 billion dollars per year in the United States. As we know IBD, represents a complex disease that has many related complications and the costs of treating these patients remains substantial.
The primary aim of our study was to assess the differences in cost in patients admitted for inflammatory bowel disease to teaching and non-teaching hospitals. We also evaluated length of stay, patient demographics, primary payer information, hospital bed size, hospital region, procedures performed, and IBD related complications.
Methods: The National Inpatient Sample (NIS) is the largest all-payer inpatient database consisting of approximately 20% of all inpatient admissions to nonfederal hospitals in the United States. We collected data from years 2008 to 2014. Cases of IBD flare were identified using the International Classification of Diseases, Ninth Edition, Clinical Modification codes. Differences in cost, length of stay, patient demographics, primary payer information, hospital bed size, hospital region, procedures performed, and IBD related complications were evaluated for patients with IBD admitted to teaching and non-teaching hospitals.
Results: Between 2008 and 2014, there were 622,444 cases of IBD admissions identified. There were 346,528 cases admitted to teaching hospitals and 275,916 cases admitted to non-teaching hospitals. The costs in dollars per case in the teaching hospital group for CD and UC were $12,168 and $14,558, respectively, versus $9,648 for CD and 10,572 for UC (p< 0.001) in the non-teaching hospital group. The teaching hospital group did have higher IBD related complications, including fistula or abscess, strictures, obstruction, perianal abscesses, and malnutrition. Despite the increase in cost in the teaching hospital group, the length of stay was similar in both groups (p=0.245).
Discussion: Our results showed the costs were higher for IBD exacerbations in the teaching hospital group. Despite having higher costs and having more IBD related complications in certain areas, the length of stay was similar between both groups. Prospective studies can further evaluate the utilization of resources in this complex disease.
Citation: Kalpesh Patel, MD, Pavan Patel, MD, Grace H. Yang, MD, Siddharth Verma, MD, JD. P0473 - HOSPITAL TEACHING STATUS ON HEALTHCARE EXPENDITURE AMONGST PATIENTS ADMITTED FOR INFLAMMATORY BOWEL DISEASE IN THE U.S.. Program No. P0473. ACG 2019 Annual Scientific Meeting Abstracts. San Antonio, Texas: American College of Gastroenterology.