Determinants of Hospital Costs of Inflammatory Bowel Disease

Rate of hospital admission for inflammatory bowel disease (IBD) and its related cost has an increasing trend worldwide. Iran has an increasing number of patients with IBD. In this study, we aimed to identify in-hospital costs of patients with IBD and its determinants in two tertiary hospitals in the south of Iran.

Applying relevant ICD (International Classification of Diseases) codes, records and hospital bills of all hospitalized patients with IBD during 2013-2015 were reviewed. Annual hospitalization cost per patient, cost per hospitalization, and daily cost during hospital admissions were also estimated. Predictors of total hospital admission costs were evaluated using Stata SE .11. A significant level was set at 0.05.

158 patients with a median age of 35 years admitted to the hospitals during the study period. Most patients were female (63.3%). The median length for hospital stay (LOS) was 3 days. The total hospital cost of IBD was 843,640 International US Dollar (IUSD). Costs were more for patients with ulcerative colitis (UC) than Crohn’s disease (CD). Daily cost during hospital admissions was more than 700 IUSD. Predictors for all three quartiles of total hospital cost for UC were: LOS, living status on check out, and year of study and for CD was LOS, all with p < 0.001.

This study showed that patients with UC had higher hospital costs than patients with CD. LOS was a strong predictor for the total hospital cost of IBD. There was a time trend for increasing cost in UC. Living status on discharge strongly predicted higher total hospital costs for patients with UC. Further prospective studies with larger sample size on direct as well as the indirect cost of IBD and its determinants are strongly recommended.