title: Multivariate analysis of factors influencing medical costs of acute pancreatitis hospitalizations based on a national administrative database.
abstract: BACKGROUND
  Little information is available on the analysis of medical costs of acute pancreatitis hospitalizations.
  
  
  OBJECTIVE
  This study aimed to determine the factors affecting medical costs of patients with acute pancreatitis during hospitalization using a Japanese administrative database.
  
  
  METHODS
  A total of 7193 patients with acute pancreatitis were referred to 776 hospitals. We defined "patients with high medical costs" as patients whose medical costs exceeded the 90th percentile in medical costs during hospitalization and identified the independent factors for patients with high medical costs with and without controlling for length of stay.
  
  
  RESULTS
  Multiple logistic regression analysis demonstrated that necrosectomy was the most significant factor for medical costs of acute pancreatitis during hospitalization. The odds ratio of necrosectomy was 33.64 (95% confidence interval, 14.14-80.03; p<0.001). Use of an intensive care unit was the most significant factor for medical costs after controlling for LOS. The OR of an ICU was 6.44 (95% CI, 4.72-8.81; p<0.001).
  
  
  CONCLUSIONS
  This study demonstrated that necrosectomy and use of an ICU significantly affected the medical costs of acute pancreatitis hospitalization. These results highlight the need for health care implementations to reduce medical costs whilst maintaining the quality of patient care, and targeting patients with severe acute pancreatitis.
authors.affiliation: Department of Preventive Medicine and Community Health, School of Medicine, University of Occupational and Environmental Health, Kitakyushu 807-8555, Japan. amurata@med.uoeh-u.ac.jp
authors.forename: Atsuhiko
authors.initials: A
authors.lastname: Murata
authors.forename: Shinya
authors.initials: S
authors.lastname: Matsuda
authors.forename: Toshihiko
authors.initials: T
authors.lastname: Mayumi
authors.forename: Kohji
authors.initials: K
authors.lastname: Okamoto
authors.forename: Kazuaki
authors.initials: K
authors.lastname: Kuwabara
authors.forename: Yukako
authors.initials: Y
authors.lastname: Ichimiya
authors.forename: Yoshihisa
authors.initials: Y
authors.lastname: Fujino
authors.forename: Tatsuhiko
authors.initials: T
authors.lastname: Kubo
authors.forename: Kenji
authors.initials: K
authors.lastname: Fujimori
authors.forename: Hiromasa
authors.initials: H
authors.lastname: Horiguchi
mesh_terms: D000368:Aged; D003365:Costs and Cost Analysis; D005260:Female; D006739:Hospital Administration / Q000706:statistics & numerical data*; D017721:Hospital Costs / Q000706:statistics & numerical data*; D006760:Hospitalization / Q000191:economics* / Q000706:statistics & numerical data; D006801:Humans; D007564:Japan; D008297:Male; D015999:Multivariate Analysis; D019283:Pancreatitis, Acute Necrotizing / Q000191:economics* / Q000628:therapy