Health-Care Utilization, Costs, and the Burden of Disease Related to Acute Diverticulitis in the United States

Abstract

Introduction: Diverticulitis, defined as inflammation, infection, or both occurring within colonic diverticula is a common inpatient diagnosis. Limited data exists regarding the rate and costs associated with inpatient admissions for acute diverticulitis. The aim of this study was to analyze a national database of U.S. hospitals to determine the incidence and inpatient costs of associated with acute diverticulitis Methods: We analyzed the National Inpatient Sample Database (NIS) for all subjects in which acute colonic diverticulitis; (ICD code 562.11, 562.13) was the principal discharge diagnosis during the period from 1997-2012. The NIS is the largest publicly available,all-payer inpatient care database in the United States. It contains data from approximately 8 million hospital stays each year. A Chi-squared test for trend was applied analyzethe number of hospital discharges, the length of hospital stay (LOS) and the related hospital costs over the study period. Results: In 1997 there were 143,400 admissions with a principal discharge diagnosis of acute colonic diverticulitis as compared to 227,935 in 2012 (GoF test, p < 0.001). The rate of discharge per 100000 persons decreased from 52.6 to 72.6 (p < 0.001 over the same time period. Moreover, the mean LOS decreased by 23 % between 1997 and 2012 from 6.1 days to 4.7 days (p < 0.001). However, during this period the mean hospital costs increased by 149 % from $14,085 per patient in 1997 to $35,171 per patient in 2012 (p < 0.001). Furthermore, the in-hospital mortality rate decreased significantly from 1.35 % in 1997 to 0.49% in 2012 (p < 0.001, Figure 1). There was no difference in inpatient mortality in patients who live in low-income area versus high-income area; socioeconomic status was stratified according to the patient's home zip code. Figure 2 represents distribution total admission, length of stay, inpatient mortality, charge in 2012 year and its variation with age, sex, income, payer, bed size of hospital.Figure 1Figure 2Conclusion: The number of inpatient admissions and rate of discharge for acute colonic diverticulitis has markedly decreased over the last 16 years with a concomitant rise in hospital costs.The in-patient mortality rate, however, has decreased significantly. These trends may reflect improvement dietary habits as well as other risk factor modifications for the occurrence of acute diverticulitis. Further studies are needed to confirm this association.Figure 3