The burden of inpatient costs in inflammatory bowel disease and opportunities to optimize care: A single metropolitan Australian center experience
Date
2010
Authors
Van Langenberg, D.
Simon, S.
Holtmann, G.
Andrews, J.
Editors
Advisors
Journal Title
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Volume Title
Type:
Journal article
Citation
Journal of Crohn's and Colitis, 2010; 4(4):413-421
Statement of Responsibility
Daniel R. van Langenberg, Stephen B. Simon, Gerald J. Holtmann, Jane M. Andrews
Conference Name
Abstract
Background and aims: Inflammatory bowel disease (IBD) causes significant morbidity, frequently resulting in hospital admission and resection surgery. However, little is known about: 1. how IBD patients' inpatient healthcare utilisation compares to other inpatients and 2. whether there are potentially modifiable factors which may influence this. Methods: Over five months a cohort of admitted IBD patients were acquired and each assigned five admitted, age and gender matched controls at a single tertiary center. Data compared over 15months included: total cumulative length of stay (TLoS), number of admissions (index and subsequent re-admissions), inpatient costs, care complexity (defined by relative stay index [RSI]), and disease-specific factors amongst the IBD cohort. Data were confirmed by case notes review. Results: There were 102 IBD patients and 510 controls (median age 44years, 57% female). IBD patients had more re-admissions (mean 1.72 vs 1.55, p=0.002) and longer TLoS (median 6.8 vs 3.4days, p<0.0001) than controls. Both median cumulative cost of inpatient healthcare and RSI were also higher in IBD compared to controls ($7052 vs $5470 and RSI 362% vs 293%, each p<0.008). IBD patients seen by a gastroenterologist prior to their index admission had fewer re-admissions (mean 1.37 vs 2.02, p=0.016,) and tended to have lower total cumulative inpatient costs than those without prior Gastroenterologist review (median $6439 vs $9479, p=0.069). Conclusions: IBD patients have significantly greater inpatient healthcare utilization, complexity and costs than age and gender matched, hospitalized controls. Prior gastroenterologist care in IBD may reduce subsequent admission rates, and inpatient-related costs.
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Dissertation Note
Provenance
Description
Conference presentation: Part of the data from this study has been presented in abstract form at Digestive Disease Week, Chicago, May 31st 2009.
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Crown Copyright © 2010. Published by Elsevier Inc. All rights reserved.