A national inpatient cost estimate of percutaneous endoscopic gastrostomy (PEG)-associated aspiration pneumonia.
OBJECTIVE
To present national estimates of the prevalence and costs of inpatient admissions for aspiration pneumonia (AP) associated with percutaneous endoscopic gastrostomies (PEGs) inserted before or during an admission.


METHODS
Retrospective analysis using medical claims.


METHODS
National estimates of the prevalence of inpatient admissions associated with AP and mortality rates were developed, using data from the Nationwide Inpatient Sample of the Hospital Cost and Utilization Project (HCUP-3) Database. The MEDSTAT Group's MarketScan Private Pay Fee-for-Service (FFS) and Medicare FFS databases were used to calculate the percentage of admissions for AP that were preceded by a PEG or that entailed a PEG placement. Associated statistics, such as average length of stay and mean payments for these admissions, also were estimated.


RESULTS
Approximately 300,000 inpatient admissions for AP took place in the United States in 1995, of which roughly 70,000 (23.9%) resulted in death. Approximately 10% of all AP admissions occurred after or entailed a PEG placement. After adjusting for differences in patients' age, gender, and health status, the total mean payments were estimated to be $26,618 per patient. This per-patient estimate translates into a national estimate of the cost of PEG-associated AP of approximately $808.2 million.


CONCLUSIONS
The cost of PEG-associated AP is relatively high, as estimated in this study. The high inpatient mortality rates of AP imply that future efforts should be directed toward preventing AP.
Siddique
R
R
Janssen Pharmaceutica, Titusville, NJ, USA.
Neslusan
C A
CA
Crown
W H
WH
Crystal-Peters
J
J
Sloan
S
S
Farup
C
C
D000293:Adolescent; D000328:Adult; D000368:Aged; D002648:Child; D002675:Child, Preschool; D017281:Cost of Illness; D005260:Female; D005773:Gastroscopy / Q000009:adverse effects*; D005774:Gastrostomy / Q000009:adverse effects* / Q000379:methods; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D007349:Insurance, Health, Reimbursement; D008297:Male; D008875:Middle Aged; D011015:Pneumonia, Aspiration / Q000191:economics* / Q000453:epidemiology / Q000209:etiology*; D015995:Prevalence