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Applied Health Economics and Health Policy

, Volume 17, Issue 1, pp 77–91 | Cite as

Trends and Factors Associated with Hospitalization Costs for Inflammatory Bowel Disease in the United States

  • Fang XuEmail author
  • Yong Liu
  • Anne G. Wheaton
  • Kristina M. Rabarison
  • Janet B. Croft
Original Research Article

Abstract

Background

Few studies have addressed recent trends in hospitalization costs for inflammatory bowel disease (IBD).

Objective

We explored trends and described patient and hospital factors associated with hospitalization costs for IBD.

Methods

Using data from the 2003–2014 National Inpatient Sample for adults aged ≥ 18 years, we estimated costs using multivariable linear models and assessed linear trends by time periods using piecewise linear regressions.

Results

In 2014, there were an estimated 56,290 hospitalizations for Crohn’s disease (CD), with a mean cost of US$11,345 and median cost of US$7592; and 33,585 hospitalizations for ulcerative colitis (UC), with a mean cost of US$13,412 and median cost of US$8873. Higher costs were observed among Hispanic [adjusted cost ratio (ACR) = 1.07; 95% confidence interval (CI) = 1.00–1.14; p = 0.04] or other non-Hispanic (ACR = 1.09; 95% CI = 1.02–1.17; p = 0.01) CD patients than for non-Hispanic White CD patients. For UC patients, higher costs were observed among men (ACR = 1.09; 95% CI = 1.05–1.13; p < 0.001) compared with women and among patients aged 35–44 years, 45–54 years, and 55–64 years compared with those aged 18–24 years. Among all patients, factors associated with higher costs included higher household income, more comorbidities, and hospitals that were government nonfederal versus private, were large versus small, and were located in the West versus Northeast regions. From 2003 to 2008, total costs increased annually by 3% for CD (1.03; 95% CI = 1.02–1.05; p < 0.001) and 4% for UC (1.04; 95% CI = 1.02–1.06; p < 0.001), but remained unchanged from 2008 to 2014.

Conclusions

The findings are important to identify IBD patients with higher hospitalization costs and to inform policy plans on hospital resource allocation.

Notes

Author Contributions

Study design: FX, YL, JBC. Study analysis: FX, YL, KMR. Results interpretation: FX, YL, AGW, KMR, JBC. Manuscript writing: FX, YL, AGW, KMR, JBC. Manuscript approval: FX, YL, AGW, KMR, JBC.

Compliance with Ethical Standards

Funding

The findings and conclusions in this report are those of the authors and do not necessarily represent the official position of the Centers for Disease Control and Prevention.

Conflict of Interest

Fang Xu, Yong Liu, Anne G. Wheaton, Kristina M. Rabarison, and Janet B. Croft have no conflict of interest in the study.

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Copyright information

© This is a U.S. government work and its text is not subject to copyright protection in the United States; however, its text may be subject to foreign copyright protection 2018

Authors and Affiliations

  • Fang Xu
    • 1
    Email author
  • Yong Liu
    • 1
  • Anne G. Wheaton
    • 1
  • Kristina M. Rabarison
    • 1
  • Janet B. Croft
    • 1
  1. 1.Division of Population Health, Centers for Disease Control and PreventionNational Center for Chronic Disease Prevention and Health PromotionAtlantaUSA

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