Prediction of resource utilization and case cost for acute nonvariceal upper gastrointestinal hemorrhage at a Canadian community hospital

OBJECTIVE: Upper gastrointestinal hemorrhage (UGIH) is common, and thus imp oses a substantial burden on health care resources. We describe resource ut ilization and cost for management of acute nonvariceal UGIH, and studied th eir variation among population subgroups. METHODS: Resource utilization and direct medical case costs were extracted for consecutive admissions for nonvariceal UGIH at a large community hospit al in southern Ontario through chart review and adaptation of an administra tive case cost database. Univariate and multiple regression models were the n developed to identify independent demographic predictors of case cost and length of stay. RESULTS: Among 116 eligible admissions the average length of stay and case cost were 4.26 days and Can$2690, respectively (Can$1 = US$0.70). Both cost and length of stay demonstrated significant univariate relationships with age, comorbid illness, prior peptic ulcer disease (PUD), and prior UGIH. Ag e and prior PUD persisted as independent predictors in multiple regression models. An inverse transformation of total case cost allowed these variable s to explain 26% of the total variance. CONCLUSIONS: Resource utilization for management of acute nonvariceal UGIH at a Canadian community hospital varies substantially among population subg roups, but correlates independently with age and prior ulcer history. Caref ul attention must be paid to practice environments and demographic profiles before economic models of strategies to prevent or treat UGIH are applied to specific subpopulations. (Am J Gastroenterol 1999;94:1841-1846. (C) 1999 by Am. Coll. of Gastroenterology).