A longitudinal analysis of the epidemiology and economic impact of inpatient admissions for chronic pancreatitis in the United States

Asim Shuja, Asad Ur Rahman, Wasseem Skef, Carmen Smotherman, Jian Guan, Miguel Malespin, Silvio del Melo

Research output: Contribution to journalArticle

Abstract

Background Chronic pancreatitis (CP) is a chronic, debilitating disorder associated with multiple complications, frequently necessitating hospitalization. The aim of this study was to investigate the longitudinal trends for hospitalization, mean length of stay (LOS), and cost associated with inpatient admissions for CP across the United States. Methods Using the Nationwide Inpatient Sample, all hospitalizations between 1997 and 2014 were analyzed. We examined annual data for rate of hospitalization, average LOS and cost for CP inpatient admissions. Trends were described over the surveillance period. Results Between 1997 and 2014, the number of hospitalizations for patients with a primary discharge diagnosis of CP decreased by 41.5% (P<0.001). While the average LOS decreased by 21.2% from 6.2 days in 1997 to 4.9 days in 2014 (P<0.001), the mean charges for CP-related hospital admissions increased by 308.5% from $12,725 in 1997 to $39,260 (adjusted for inflation) in 2014 (P<0.001). The risk of a discharge for CP significantly increased from 1997-2014 for the 1-17 year age group (relative risk 1.518, 95% confidence interval 1.516-1.520; P<0.0001), while it significantly decreased over time for all the other age groups. Conclusions Although it is reassuring that the average LOS has reduced, the cost associated with these hospitalizations has almost tripled. We postulate that the increase in cost is likely attributable to a greater number of studies and/or interventions. In order to deliver more cost-conscious care, further investigation is required into the effect that these additional investigations and interventions have on specific endpoints, including disease-specific and all-cause morbidity and mortality.

Original languageEnglish (US)
Pages (from-to)499-505
Number of pages7
JournalAnnals of Gastroenterology
Volume31
Issue number4
DOIs
StatePublished - Jul 3 2018
Externally publishedYes

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Chronic Pancreatitis
Inpatients
Epidemiology
Hospitalization
Economics
Length of Stay
Costs and Cost Analysis
Age Groups
Economic Inflation
Confidence Intervals
Morbidity
Mortality

Keywords

  • Admissions
  • Chronic pancreatitis
  • Trend

ASJC Scopus subject areas

  • Gastroenterology

Cite this

A longitudinal analysis of the epidemiology and economic impact of inpatient admissions for chronic pancreatitis in the United States. / Shuja, Asim; Ur Rahman, Asad; Skef, Wasseem; Smotherman, Carmen; Guan, Jian; Malespin, Miguel; del Melo, Silvio.

In: Annals of Gastroenterology, Vol. 31, No. 4, 03.07.2018, p. 499-505.

Research output: Contribution to journalArticle

Shuja, Asim ; Ur Rahman, Asad ; Skef, Wasseem ; Smotherman, Carmen ; Guan, Jian ; Malespin, Miguel ; del Melo, Silvio. / A longitudinal analysis of the epidemiology and economic impact of inpatient admissions for chronic pancreatitis in the United States. In: Annals of Gastroenterology. 2018 ; Vol. 31, No. 4. pp. 499-505.
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AB - Background Chronic pancreatitis (CP) is a chronic, debilitating disorder associated with multiple complications, frequently necessitating hospitalization. The aim of this study was to investigate the longitudinal trends for hospitalization, mean length of stay (LOS), and cost associated with inpatient admissions for CP across the United States. Methods Using the Nationwide Inpatient Sample, all hospitalizations between 1997 and 2014 were analyzed. We examined annual data for rate of hospitalization, average LOS and cost for CP inpatient admissions. Trends were described over the surveillance period. Results Between 1997 and 2014, the number of hospitalizations for patients with a primary discharge diagnosis of CP decreased by 41.5% (P<0.001). While the average LOS decreased by 21.2% from 6.2 days in 1997 to 4.9 days in 2014 (P<0.001), the mean charges for CP-related hospital admissions increased by 308.5% from $12,725 in 1997 to $39,260 (adjusted for inflation) in 2014 (P<0.001). The risk of a discharge for CP significantly increased from 1997-2014 for the 1-17 year age group (relative risk 1.518, 95% confidence interval 1.516-1.520; P<0.0001), while it significantly decreased over time for all the other age groups. Conclusions Although it is reassuring that the average LOS has reduced, the cost associated with these hospitalizations has almost tripled. We postulate that the increase in cost is likely attributable to a greater number of studies and/or interventions. In order to deliver more cost-conscious care, further investigation is required into the effect that these additional investigations and interventions have on specific endpoints, including disease-specific and all-cause morbidity and mortality.

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