The cost of hospitalization in Crohn's disease

OBJECTIVE: The aim of this study was to evaluate the demographics, resource use, and costs associated with hospitalization of Crohn's disease patients . METHODS: All patients hospitalized at our institution from 7/1/96 to 6/30/9 7 with a primary diagnosis of "Crohn's Disease" were analyzed using a compu terized database. Data are presented "per hospitalization." RESULTS: A total of 175 hospitalizations (147 patients) were identified. Me an patient age was 36.5 yr; 61% were female; 82% Caucasian. Payer mix was m ost commonly contracted (57%), commercial (21%), or Medicare (13%). 57% of hospitalizations had a primary surgical procedure; the remainder were medic al. Average length of stay was 8.7 days (surgical, 9.6 days; medical, 7.5 d ays). The average cost of hospitalization, excluding physician fees, was $1 2,528 (surgical, $14,409; medical, $10,020), whereas average charges were $ 35,378 (surgical, $46,354; medical, $20,744), including physician fees, whi ch averaged $7,249 (surgical, $11,217; medical, $1,959). Mean reimbursement s were $21,968 (surgical, $28,946; medical, $12,666) with average weighted reimbursement rates of 60.17% of hospital charges, 69.57% of physician fees . The distribution of costs across subcategories was: Surgery (39.6%), Phar macy (18.6%), Laboratory (3.8%), Radiology (2.1%), Pathology (0.8%), Endosc opy (0.3%), and Other Hospital Costs (34.9%). Of the hospitalizations, 87% included treatment with steroids, 23% with immunomodulators, and 14% with a minosalicylates; 27% included the administration of total parenteral nutrit ion, which accounted for 63% of the total pharmacy costs. CONCLUSIONS: Surgery accounts for the majority of hospitalizations, nearly 40% of their total costs, and 75% of overall charges and reimbursements. Th erapy that decreases the number of surgical hospitalizations should substan tially reduce inpatient Crohn's disease costs, as well as overall costs. (C ) 2000 by Am. Cell. of Gastroenterology.