title: Intensive treatment for adults with anorexia nervosa: The cost of weight restoration.
abstract: Weight restoration in anorexia nervosa (AN) is associated with lower relapse risk; however rate of weight gain and percent of patients achieving weight restoration (BMI ≥ 19 at discharge) vary among treatment programs. We compared both cost/pound of weight gained and cost of weight restoration in a hospital-based inpatient (IP)-partial hospitalization (PH) eating disorders program to estimates of these costs for residential treatment.
  
  
  
  All adult first admissions to the IP-PH program with AN (N = 314) from 2003 to 2015 were included. Cost of care was based on hospital charges, rates of weight gain, and weight restoration data. Results were compared with residential treatment costs extracted from a national insurance claims database and published weight gain data.
  
  
  
  Average charge/day in the IP-PH program was $2295 for IP and $1567 for PH, yielding an average cost/pound gained of $4089 and $7050, respectively, with 70% of patients achieving weight restoration. Based on published mean weight gain data and conservative cost/day estimates, residential treatment is associated with higher cost/pound, and both higher cost and lower likelihood of weight restoration for most patients.
  
  
  
  The key metrics used in this study are recommended for comparing the cost-effectiveness of intensive treatment programs for patients with AN.
authors.affiliation: Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, Maryland.
authors.forename: Angela S
authors.identifier: 0000-0003-1355-729X
authors.initials: AS
authors.lastname: Guarda
authors.affiliation: Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, Maryland.
authors.forename: Colleen C
authors.initials: CC
authors.lastname: Schreyer
authors.affiliation: Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, Maryland.
authors.forename: Laura K
authors.initials: LK
authors.lastname: Fischer
authors.affiliation: Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, Maryland.
authors.forename: Jennifer L
authors.initials: JL
authors.lastname: Hansen
authors.affiliation: Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, Maryland.
authors.forename: Janelle W
authors.initials: JW
authors.lastname: Coughlin
authors.affiliation: Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, Maryland.
authors.forename: Michael J
authors.initials: MJ
authors.lastname: Kaminsky
authors.affiliation: Department of Psychiatry, Columbia University Medical Center, New York.|Department of Psychiatry, Weill Cornell Medical College, New York.
authors.forename: Evelyn
authors.initials: E
authors.lastname: Attia
authors.affiliation: Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, Maryland.
authors.forename: Graham W
authors.initials: GW
authors.lastname: Redgrave
mesh_terms: D000328:Adult; D000856:Anorexia Nervosa / Q000191:economics / Q000628:therapy*; D017281:Cost of Illness; D003362:Cost-Benefit Analysis; D005260:Female; D017721:Hospital Costs; D006760:Hospitalization / Q000191:economics*; D006801:Humans; D007902:Length of Stay / Q000191:economics; D008297:Male; D008396:Maryland; D010351:Patient Discharge; D012008:Recurrence; D012189:Retrospective Studies; D015430:Weight Gain / Q000502:physiology
keywords: anorexia nervosa; cost; cost-effectiveness; inpatient; partial hospitalization; refeeding; residential treatment; target weight; weight gain; weight restoration