Division of Population Health, Centers for Disease Control and Prevention, National Center for Chronic Disease Prevention and Health Promotion, 4770 Buford Highway NE, Mailstop F-78, Atlanta, GA, 30341, USA.
Appl Health Econ Health Policy. 2019 Feb;17(1):77-91. doi: 10.1007/s40258-018-0432-4.
Few studies have addressed recent trends in hospitalization costs for inflammatory bowel disease (IBD).
We explored trends and described patient and hospital factors associated with hospitalization costs for IBD.
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.
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.
The findings are important to identify IBD patients with higher hospitalization costs and to inform policy plans on hospital resource allocation.
很少有研究探讨炎症性肠病（IBD）住院费用的近期趋势。
我们探讨了 IBD 住院费用的趋势，并描述了与住院费用相关的患者和医院因素。
利用 2003-2014 年全国成年住院患者样本数据，我们使用多变量线性模型估计了费用，并使用分段线性回归评估了按时间段的线性趋势。
2014 年，估计有 56290 例克罗恩病（CD）住院治疗，平均费用为 11345 美元，中位数费用为 7592 美元；33585 例溃疡性结肠炎（UC）住院治疗，平均费用为 13412 美元，中位数费用为 8873 美元。西班牙裔[调整成本比（ACR）=1.07；95%置信区间（CI）=1.00-1.14；p=0.04]或其他非西班牙裔（ACR=1.09；95%CI=1.02-1.17；p=0.01）CD 患者的费用高于非西班牙裔白种人 CD 患者。对于 UC 患者，与女性相比，男性（ACR=1.09；95%CI=1.05-1.13；p<0.001）和 35-44 岁、45-54 岁和 55-64 岁患者的费用高于 18-24 岁患者。在所有患者中，与费用较高相关的因素包括较高的家庭收入、更多的合并症，以及政府非联邦医院与私人医院、大型医院与小型医院、西部地区医院与东北地区医院。从 2003 年到 2008 年，CD 的总费用每年增加 3%（1.03；95%CI=1.02-1.05；p<0.001），UC 的总费用每年增加 4%（1.04；95%CI=1.02-1.06；p<0.001），但从 2008 年到 2014 年保持不变。
这些发现对于确定住院费用较高的 IBD 患者很重要，并为医院资源配置的政策计划提供信息。
