Multivariate analysis of factors influencing medical costs of acute pancreatitis hospitalizations based on a national administrative database

• Published in: Digestive and liver disease 2012-02, Vol.44 (2), p.143-148
• Main Authors: Murata, Atsuhiko, Matsuda, Shinya, Mayumi, Toshihiko, Okamoto, Kohji, Kuwabara, Kazuaki, Ichimiya, Yukako, Fujino, Yoshihisa, Kubo, Tatsuhiko, Fujimori, Kenji, Horiguchi, Hiromasa
• Format: Article
• Language: English
• Subjects: Acute pancreatitis; Aged; Costs and Cost Analysis; Female; Gastroenterology and Hepatology; Health care costs; Hospital Administration - statistics & numerical data; Hospital Costs - statistics & numerical data; Hospitalization - economics; Hospitalization - statistics & numerical data; Humans; Intensive care unit; Japan; Male; Multivariate Analysis; Necrosectomy; Pancreatitis, Acute Necrotizing - economics; Pancreatitis, Acute Necrotizing - therapy
• ISSN: 1590-8658; 1878-3562
• DOI: 10.1016/j.dld.2011.08.011

Abstract Background Little information is available on the analysis of medical costs of acute pancreatitis hospitalizations. Aim 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). Conclusion 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.