PREVALENCE AND COST OF HOSPITALIZATION FOR GASTROINTESTINAL COMPLICATIONS RELATED TO PEPTIC-ULCERS WITH BLEEDING OR PERFORATION - COMPARISON OF 2 NATIONAL DATABASES

The purpose of this study was to determine the prevalence and cost of hospitalization for upper gastrointestinal complications, including pe ptic ulcers with hemorrhage or perforation. Upper gastrointestinal com plications and corresponding economic data were obtained from two sour ces. The first was a 20% sample of all community hospital discharges ( about 6 million per year) from 11 states for 1991 and 1992 (Hospital C ost Utilization Project; HCUP-3). The second source of data was a clai ms database for employees of large US corporations and their dependent s for 1992, 1993, and 1994 (about 3.5 million covered lives per year; MarketScan). A group of ICD-9 codes for the diagnosis of peptic and ga stroduodenal ulcers with bleeding or perforation were used to identify hospital admissions because of upper gastrointestinal complications. Similar patterns were observed across the MarketScan and HCUP-3 databa ses regarding hospitalization with diagnoses related to gastrointestin al complications identified according to the ICD-9 codes. The average age of patients with upper gastrointestinal complications was 66 years in the HCUP-3 database and 52 years in the MarketScan database. The a verage annual rates of upper gastrointestinal complications as a prima ry or secondary diagnosis were 6.4 and 6.7 per 1000 discharges for 199 1 and 1992, respectively (HCUP-3), and 4.3, 4.2, and 4.9 per 1000 admi ssions for 1992, 1993, and 1994, respectively (MarketScan). The averag e length of stay for upper gastrointestinal complications as a primary diagnosis was 7.8 days in 1991 and 7.5 days in 1992 (HCUP-3) and 6.1, 5.1, and 5.1 days in 1992, 1993, and 1994, respectively (MarketScan). The national average total charge for hospitalization for gastrointes tinal problems as a primary diagnosis was $12,970 in 1991 and $14,294 in 1992 (HCUP-3). The average total reimbursement for hospitalizations related to upper gastrointestinal problems was $15,309 in 1992, $12,9 87 in 1993, and $13,150 in 1994 (MarketScan). Hospital admissions for upper gastrointestinal complications are expensive. The rate and cost per admission are higher for the older population. The results on the elements covered by both databases are consistent. Therefore the datab ases complement each other on the type of information abstracted.