Inpatient healthcare trends among adult cystic fibrosis patients in the U.S

• Published in: Pediatric pulmonology 2012-03, Vol.47 (3), p.245-251
• Main Authors: Kopp, Benjamin T., Wang, Wei, Chisolm, Deena J., Kelleher, Kelly J., McCoy, Karen S.
• Format: Article
• Language: English
• Subjects: Adolescent; Adult; Biological and medical sciences; Cystic Fibrosis - economics; Cystic Fibrosis - therapy; Databases, Factual; Delivery of Health Care - economics; Delivery of Health Care - trends; Economics, Hospital - trends; Errors of metabolism; Female; General aspects; geographic factors; healthcare utilization; Hospital Charges - trends; Hospital Costs - trends; Hospitalization - economics; Hospitals - trends; Hospitals, Pediatric - economics; Hospitals, Pediatric - trends; Humans; Inpatients - statistics & numerical data; Length of Stay - economics; Male; Medical sciences; Metabolic diseases; Miscellaneous hereditary metabolic disorders; Pneumology; socioeconomic factors; United States
• ISSN: 8755-6863; 1099-0496
• DOI: 10.1002/ppul.21535

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. Pediatr Pulmonol. 2012; 47:245–251. © 2011 Wiley Periodicals, Inc.