Abstract
Introduction
Increasing attention is being focused on reigning in escalating costs of healthcare, i.e. trying to ‘bend the cost curve’. In gastroenterology (GI), inpatient hospital care represents a major component of overall costs. This study aimed to characterize the trend in cost of care for GI-related hospitalizations in recent years and to identify the most costly diagnostic groups.
Methods
All hospital inpatients admitted between January 2008 and December 2009 with a primary diagnosis of one of the six most common GI-related Diagnosis Related Groups (DRGs) in this hospital system were identified; all DRGs contained at least 40 patients during the study period. Patient Level Costing (PLC) was used to express the total cost of hospital care for each patient; PLC comprised a weighted daily bed cost plus cost of all medical services provided (e.g., radiology, pathology tests) calculated according to an activity-based costing approach; cost of medications were excluded. All costs were discounted to 2009 values. Mean length of stay (LOS) was also calculated for each DRG.
Results
Over 2 years, 470 patients were admitted with one of the six most common GI DRGs. Mean cost of care increased from 2008 to 2009 for all six DRGs with the steepest increases seen in ‘GI hemorrhage (non-complex)’ (31 % increase) and ‘Cirrhosis/Alcoholic hepatitis (non-complex)’ (45 % increase). No differences in readmission rates were observed over time. There was a strong correlation between year-to-year change in costs and change in mean LOS, r = 0.93.
Conclusion
The cost of GI-related inpatient care appears to be increasing in recent years with the steepest increases observed in non-complex GI hemorrhage and non-complex Cirrhosis/Alcoholic hepatitis. Efforts to control the increasing costs should focus on these diagnostic categories.
Similar content being viewed by others
References
http://www.oecd.org/document/16/0,3746,en_2649_37407_2085200_1_1_1_37407,00.html. Accessed 3 Dec 2012
Smith TJ, Hillner BE (2011) Bending the cost curve in cancer care. New Eng J Med 364(21):2060–2065
Shortell SM (2009) Bending the cost curve: a critical component of health care reform. JAMA 302(11):1223–1224
Antos J, Bertko J, Chernew M et al (2009) Bending the curve: effective steps to address long-term healthcare spending growth. Am J Manag Care 15(10):676–680
Cornes P (2012) The economic pressures for biosimilar drug use in cancer medicine. Target Oncol Suppl 1:S57–S67 (PMID: 22249658)
Taheri PA, Butz DA, Greenfield LJ (2000) Length of stay has minimal impact on the cost of hospital admission. J Am Coll Surg 191(2):123–130
Quirk DM, Barry MJ, Aserkoff B et al (1997) Physician speciality and variations in the cost of treating patients with acute upper gastrointestinal bleeding. Gastroenterology 113(5):1443–1448
Pardo A, Durandez R, Hernandez M et al (2002) Impact of physician speciality on the cost of nonvariceal upper GI bleeding care. Am J Gastroenterol 97(6):1535–1542
Slattery E, Harewood GC (2012) Speciality specific admission: a cost-effective intervention? Ir J Med Sci 181(1):87–91
Mitka M (2009) Growth in health care spending slows, but still outpaces rate of inflation. JAMA 25;301(8): 815–816 (PMID: 19244182)
Armellino D, Hussain E, Schilling ME et al (2012) Using high technology to enforce low technology safety measures: the use of third party remote video auditing and real time feedback in healthcare. Clin Infect Dis 54(1):1–7
Plotnikoff RC, Pickering MA, McCargar LJ et al (2010) Six-month follow-up and participant use and satisfaction of an electronic mail intervention promoting physical activity and nutrition. Am J Health Promot 24(4):255–259
Newgard CD, Fleischman R, Choo E et al (2010) Validation of length of hospital stay as a surrogate measure for injury severity and resource use among injury survivors. Acad Emerg Med 17(2):142–150
Conflict of interest
The authors have no conflicts of interest or financial disclosures.
Author information
Authors and Affiliations
Corresponding author
Rights and permissions
About this article
Cite this article
Slattery, E., Harewood, G.C., Murray, F. et al. “Bending the cost curve” in Gastroenterology. Ir J Med Sci 182, 629–632 (2013). https://doi.org/10.1007/s11845-013-0942-x
Received:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s11845-013-0942-x