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

Daniel R. van Langenberg, Stephen B. Simon, Gerald J. Holtmann, Jane M. Andrews

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20 Citations (Scopus)

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 15. months 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 44. years, 57% female). IBD patients had more re-admissions (mean 1.72 vs 1.55, p=0.002) and longer TLoS (median 6.8 vs 3.4. days, 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.

Original languageEnglish
Pages (from-to)413-421
Number of pages9
JournalJournal of Crohn's and Colitis
Volume4
Issue number4
DOIs
Publication statusPublished - 1 Oct 2010
Externally publishedYes

Keywords

  • Care complexity
  • Healthcare utilization
  • Inflammatory bowel disease
  • Inpatient costs
  • Surgery

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