title: Inpatient healthcare trends among adult cystic fibrosis patients in the U.S.
abstract: BACKGROUND
  Adult cystic fibrosis (CF) patients are an expanding cohort that is taken care of in a variety of hospital settings including adult centers located within pediatric institutions. This study compared costs and discharge rates among adult CF patient hospitalizations in terms of location of hospitalization.
  
  
  METHODS
  The 2007 Nationwide Inpatient Sample was utilized to identify adult CF patient admission data on patients aged 18-44. Data were separated into pediatric and adult facilities based on percentage discharge rate for patients >18. Primary outcomes measures were length of stay (LOS) and total hospital charges. Secondary predictors were geographic, primary payer, and co-morbidity effects on LOS and total hospital charges.
  
  
  RESULTS
  LOS was higher for adult CF patient admissions in pediatric facilities compared to adult facilities by a mean of 2.5 days. Mean total hospital charges were not significantly different. Adult hospitals in the Western U.S. had a mean total charge more than $50,000 greater than any region in the U.S. Self-pay patients had significantly fewer hospital days and charges across all hospital types. Adult facilities had 7% more CF patients discharged home with home healthcare use. Depressed CF patients had longer LOS by 1.5 days regardless of facility type.
  
  
  CONCLUSIONS
  LOS for adult CF inpatient admissions was significantly lower in adult facilities compared to pediatric facilities without a significant difference in hospital charges and is influenced by geographic hospital location. Depressed patients had longer lengths of stay regardless of facility type. Self-insured adult CF patients have a significant reduction in LOS and hospital charges when compared to all other payers regardless of hospital type.
authors: Section of Pulmonary Medicine, Nationwide Children's Hospital, Columbus, Ohio 43205, USA. benjamin.kopp@nationwidechildrens.org
authors: Benjamin T
authors: BT
authors: Kopp
authors: Wei
authors: W
authors: Wang
authors: Deena J
authors: DJ
authors: Chisolm
authors: Kelly J
authors: KJ
authors: Kelleher
authors: Karen S
authors: KS
authors: McCoy
mesh_terms: D000293:Adolescent; D000328:Adult; D003550:Cystic Fibrosis / Q000191:economics* / Q000628:therapy; D016208:Databases, Factual; D003695:Delivery of Health Care / Q000191:economics* / Q000639:trends*; D004469:Economics, Hospital / Q000639:trends; D005260:Female; D017722:Hospital Charges / Q000639:trends*; D017721:Hospital Costs / Q000639:trends; D006760:Hospitalization / Q000191:economics; D006761:Hospitals / Q000639:trends; D006776:Hospitals, Pediatric / Q000191:economics / Q000639:trends; D006801:Humans; D007297:Inpatients / Q000706:statistics & numerical data*; D007902:Length of Stay / Q000191:economics*; D008297:Male; D014481:United States