BACKGROUND: Hospitalization costs for ulcerative colitis (UC) following the introduction of infliximab have not been evaluated. OBJECTIVE: To study predictors of costs for UC patients who were hospitalized for a flare or colectomy. METHODS: Population-based surveillance identified adults (≥18 years of age) admitted to hospital for UC flare or colectomy between 2001 and 2009 in the Calgary Health Zone (Alberta). Medical charts were reviewed and patients stratified into three admission types: responsive to inpatient medical therapy (n=307); emergent colectomy (n=227); and elective colectomy (n=208). The annual median cost with interquartile range (IQR) was calculated. Linear regression determined the effect of admission type on hospital charges after adjusting for age, sex, smoking, comorbidities, disease extent, medication use (eg, infliximab) and year. The adjusted cost increase was presented as the percent increase with 95% CIs. Joinpoint analysis assessed for an inflection point in hospital cost after the introduction of infliximab. RESULTS: Median hospitalization cost for UC flare, emergent colectomy and elective colectomy, respectively, were: $5,499 (IQR $3,374 to $8,904), $23,698 (IQR $17,981 to $32,385) and $14,316 (IQR $11,932 to $18,331). Adjusted hospitalization costs increased approximately 6.0% annually (95% CI 4.5% to 7.5%). Adjusted costs were higher for patients who underwent an elective colectomy (percent increase cost 179.8% [95% CI 151.6% to 211.1%]) or an emergent colectomy (percent increase cost 211.1% [95% CI 183.2% to 241.6%]) than medically responsive patients. Infliximab in hospital was an independent predictor of increased costs (percent increase cost 69.5% [95% CI 49.2% to 92.5%]). No inflection points were identified. CONCLUSION: Hospitalization costs for UC increased due to colectomy and infliximab.
BACKGROUND: Hospitalization costs for ulcerative colitis (UC) following the introduction of infliximab have not been evaluated. OBJECTIVE: To study predictors of costs for UC patients who were hospitalized for a flare or colectomy. METHODS: Population-based surveillance identified adults (≥18 years of age) admitted to hospital for UC flare or colectomy between 2001 and 2009 in the Calgary Health Zone (Alberta). Medical charts were reviewed and patients stratified into three admission types: responsive to inpatient medical therapy (n=307); emergent colectomy (n=227); and elective colectomy (n=208). The annual median cost with interquartile range (IQR) was calculated. Linear regression determined the effect of admission type on hospital charges after adjusting for age, sex, smoking, comorbidities, disease extent, medication use (eg, infliximab) and year. The adjusted cost increase was presented as the percent increase with 95% CIs. Joinpoint analysis assessed for an inflection point in hospital cost after the introduction of infliximab. RESULTS: Median hospitalization cost for UC flare, emergent colectomy and elective colectomy, respectively, were: $5,499 (IQR $3,374 to $8,904), $23,698 (IQR $17,981 to $32,385) and $14,316 (IQR $11,932 to $18,331). Adjusted hospitalization costs increased approximately 6.0% annually (95% CI 4.5% to 7.5%). Adjusted costs were higher for patients who underwent an elective colectomy (percent increase cost 179.8% [95% CI 151.6% to 211.1%]) or an emergent colectomy (percent increase cost 211.1% [95% CI 183.2% to 241.6%]) than medically responsive patients. Infliximab in hospital was an independent predictor of increased costs (percent increase cost 69.5% [95% CI 49.2% to 92.5%]). No inflection points were identified. CONCLUSION: Hospitalization costs for UC increased due to colectomy and infliximab.
Authors: Ing Shian Soon; Iwona Wrobel; Jennifer C C deBruyn; Reg Sauve; David L Sigalet; Belle S Kaplan; Marie-Claude Proulx; Gilaad G Kaplan Journal: J Pediatr Gastroenterol Nutr Date: 2012-06 Impact factor: 2.839
Authors: Natalie A Molodecky; Ing Shian Soon; Doreen M Rabi; William A Ghali; Mollie Ferris; Greg Chernoff; Eric I Benchimol; Remo Panaccione; Subrata Ghosh; Herman W Barkema; Gilaad G Kaplan Journal: Gastroenterology Date: 2011-10-14 Impact factor: 22.682
Authors: Gilaad G Kaplan; Ellen P McCarthy; John Z Ayanian; Joshua Korzenik; Richard Hodin; Bruce E Sands Journal: Gastroenterology Date: 2008-01-10 Impact factor: 22.682
Authors: Gilaad G Kaplan; James Hubbard; Remo Panaccione; Abdel Aziz M Shaheen; Hude Quan; Geoffrey C Nguyen; Elijah Dixon; Subrata Ghosh; Robert P Myers Journal: Arch Surg Date: 2011-08
Authors: Shanika de Silva; Christopher Ma; Marie-Claude Proulx; Marcelo Crespin; Belle S Kaplan; James Hubbard; Martin Prusinkiewicz; Andrew Fong; Remo Panaccione; Subrata Ghosh; Paul L Beck; Anthony Maclean; Donald Buie; Gilaad G Kaplan Journal: Clin Gastroenterol Hepatol Date: 2011-07-30 Impact factor: 11.382
Authors: Gunnar Järnerot; Erik Hertervig; Ingalill Friis-Liby; Lars Blomquist; Per Karlén; Christer Grännö; Mogens Vilien; Magnus Ström; Ake Danielsson; Hans Verbaan; Per M Hellström; Anders Magnuson; Bengt Curman Journal: Gastroenterology Date: 2005-06 Impact factor: 22.682
Authors: Michael D Kappelman; Sheryl L Rifas-Shiman; Carol Q Porter; Daniel A Ollendorf; Robert S Sandler; Joseph A Galanko; Jonathan A Finkelstein Journal: Gastroenterology Date: 2008-09-17 Impact factor: 22.682
Authors: Phillip Gu; Anshika Kapur; Dalin Li; Talin Haritunians; Eric Vasiliauskas; David Q Shih; Stephan R Targan; Brennan Mr Spiegel; Dermot Pb Mcgovern; Jeanne T Black; Gil Y Melmed Journal: J Dig Dis Date: 2018-01 Impact factor: 2.325
Authors: M Ellen Kuenzig; Eric I Benchimol; Lawrence Lee; Laura E Targownik; Harminder Singh; Gilaad G Kaplan; Charles N Bernstein; Alain Bitton; Geoffrey C Nguyen; Kate Lee; Jane Cooke-Lauder; Sanjay K Murthy Journal: J Can Assoc Gastroenterol Date: 2018-11-02
Authors: Phillip Gu; Eric Clifford; Andrew Gilman; Christopher Chang; Elizabeth Moss; David I Fudman; Phillip Kilgore; Urska Cvek; Marjan Trutschl; J Steven Alexander; Ezra Burstein; Moheb Boktor Journal: Pathophysiology Date: 2022-07-18
Authors: Matthew J Brookes; John Waller; Joseph C Cappelleri; Irene Modesto; Marco D DiBonaventura; Natalie Bohm; Ruth Mokgokong; Olivia Massey; Robert Wood; Danielle Bargo Journal: BMJ Open Gastroenterol Date: 2020-09