title: The cost of hospitalization in Crohn's disease.
abstract: 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 6/30/97 with a primary diagnosis of "Crohn's Disease" were analyzed using a computerized database. Data are presented "per hospitalization."
  
  
  RESULTS
  A total of 175 hospitalizations (147 patients) were identified. Mean patient age was 36.5 yr; 61% were female; 82% Caucasian. Payer mix was most commonly contracted (57%), commercial (21%), or Medicare (13%). 57% of hospitalizations had a primary surgical procedure; the remainder were medical. Average length of stay was 8.7 days (surgical, 9.6 days; medical, 7.5 days). The average cost of hospitalization, excluding physician fees, was $12,528 (surgical, $14,409; medical, $10,020), whereas average charges were $35,378 (surgical, $46,354; medical, $20,744), including physician fees, which averaged $7,249 (surgical, $11,217; medical, $1,959). Mean reimbursements 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%), Pharmacy (18.6%), Laboratory (3.8%), Radiology (2.1%), Pathology (0.8%), Endoscopy (0.3%), and Other Hospital Costs (34.9%). Of the hospitalizations, 87% included treatment with steroids, 23% with immunomodulators, and 14% with aminosalicylates; 27% included the administration of total parenteral nutrition, 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. Therapy that decreases the number of surgical hospitalizations should substantially reduce inpatient Crohn's disease costs, as well as overall costs.
authors.affiliation: University of Chicago, Department of Medicine, Illinois, USA.
authors.forename: R D
authors.initials: RD
authors.lastname: Cohen
authors.forename: L R
authors.initials: LR
authors.lastname: Larson
authors.forename: J M
authors.initials: JM
authors.lastname: Roth
authors.forename: R V
authors.initials: RV
authors.lastname: Becker
authors.forename: L L
authors.initials: LL
authors.lastname: Mummert
mesh_terms: D000328:Adult; D000367:Age Factors; D002641:Chicago; D003284:Contract Services / Q000191:economics; D003365:Costs and Cost Analysis; D003424:Crohn Disease / Q000188:drug therapy / Q000191:economics* / Q000601:surgery; D019992:Databases as Topic; D016527:Drug Costs; D005251:Fees, Medical; D005260:Female; D017722:Hospital Charges; D017721:Hospital Costs; D006748:Hospital Departments / Q000191:economics; D006760:Hospitalization / Q000191:economics*; D006801:Humans; D007348:Insurance, Health / Q000191:economics; D007349:Insurance, Health, Reimbursement; D007902:Length of Stay; D008297:Male; D006278:Medicare / Q000191:economics; D010289:Parenteral Nutrition, Total / Q000191:economics; D012189:Retrospective Studies; D012737:Sex Factors; D013503:Surgery Department, Hospital / Q000191:economics; D014481:United States