Cost of treating an episode of variceal bleeding in a VA setting.
OBJECTIVE
The specific aims of this study were to develop a demographic description of a sample of patients presenting with bleeding esophageal varices and determine the direct health care costs of variceal bleeding.


METHODS
This was a retrospective evaluation of patients who underwent esophagogastroduodenoscopy at the Portland VA Medical Center between January 1993 and May 1997. Data sources included both electronic databases and patient medical charts. The primary unit of analysis was an episode of care, defined as an index bleed plus 6 months of follow-up or death, whichever came first.


RESULTS
The total inpatient direct cost was $1,566,904 and outpatient direct cost was $104,611, for a total of $1,671,515 for 100 bleeding episodes in 79 patients. Episodes of care for patients receiving < or =2 units of packed red blood cells were approximately a third as costly as those receiving >2 units of packed red blood cells (n = 17, $6,470 and n = 83, $17,553). The difference in costs was statistically significant (p < 0.05), and primarily attributable to hospital bed costs.


CONCLUSIONS
There is a substantial financial burden associated with this illness, primarily attributable to inpatient costs. In addition to severity of bleeding, Child's class, endoscopic findings, and the timing of pharmacological therapy seem to influence the overall cost of managing esophageal varices.
Zaman
A
A
Department of Gastroenterology, Oregon Health Sciences University, Portland 97201, USA.
Goldberg
R J
RJ
Pettit
K G
KG
Kaniecki
D J
DJ
Benner
K
K
Zacker
C
C
DiCesare
J
J
Helfand
M
M
D016527:Drug Costs; D004932:Esophageal and Gastric Varices / Q000150:complications / Q000191:economics* / Q000628:therapy*; D006471:Gastrointestinal Hemorrhage / Q000191:economics* / Q000209:etiology / Q000628:therapy*; D017048:Health Care Costs; D006295:Health Resources / Q000706:statistics & numerical data; D017721:Hospital Costs; D006787:Hospitals, Veterans; D006801:Humans; D008875:Middle Aged; D012189:Retrospective Studies; D014481:United States