The burden of inpatient costs in inflammatory bowel disease and opportunities to optimize care: A single metropolitan Australian center experience

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dc.contributor.authorVan Langenberg, D.
dc.contributor.authorSimon, S.
dc.contributor.authorHoltmann, G.
dc.contributor.authorAndrews, J.
dc.date.issued2010
dc.descriptionConference presentation: Part of the data from this study has been presented in abstract form at Digestive Disease Week, Chicago, May 31st 2009.
dc.description.abstractBackground 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.
dc.description.statementofresponsibilityDaniel R. van Langenberg, Stephen B. Simon, Gerald J. Holtmann, Jane M. Andrews
dc.identifier.citationJournal of Crohn's and Colitis, 2010; 4(4):413-421
dc.identifier.doi10.1016/j.crohns.2010.01.004
dc.identifier.issn1873-9946
dc.identifier.issn1876-4479
dc.identifier.orcidAndrews, J. [0000-0001-7960-2650]
dc.identifier.urihttp://hdl.handle.net/2440/61815
dc.language.isoen
dc.publisherElsevier BV
dc.rightsCrown Copyright © 2010. Published by Elsevier Inc. All rights reserved.
dc.source.urihttps://doi.org/10.1016/j.crohns.2010.01.004
dc.subjectInflammatory bowel disease
dc.subjectHealthcare utilization
dc.subjectSurgery
dc.subjectCare complexity
dc.subjectInpatient costs
dc.titleThe burden of inpatient costs in inflammatory bowel disease and opportunities to optimize care: A single metropolitan Australian center experience
dc.typeJournal article
pubs.publication-statusPublished

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