Episodic and Long-term Costs of Acute Pancreatitis Requiring Hospitalization Among Adults in US Clinical Practice.

Abstract

Objectives: Acute pancreatitis (AP) is associated with significant morbidity and mortality. While most patients fully recover following the acute phase of illness, some develop long-term complications. The objective of this study was to estimate short- and long-term costs among adults hospitalized with AP in US clinical practice, overall and within subgroups defined by AP cause.

Methods: A retrospective cohort design and health care claims database were employed. The study population comprised adults hospitalized for AP (first admission = index admission), and was considered overall as well as by AP cause (alcohol-induced, biliary-induced, drug-induced, cause unknown, and multiple causes). AP-related health care utilization/expenditures were evaluated during the short-term episode (index admission + encounters separated by <30 days) and long-term follow-up period (1 year from end of episode).

Results: Among the 5051 hospitalized AP patients in the study population, 7% (range by AP cause: 6%-8%) had necrosis, 22% (19%-26%) had organ failure, 12% (6%-16%) had sepsis, and 14% (9%-19%) had systemic inflammatory response syndrome. During the long-term follow-up period, rates of recurrent AP and chronic pancreatitis were 14 (8-29) and 15 (10-25), respectively, per 100 person-years. Mean AP-related expenditures were $31,119 ($22,963-$37,733) during the short-term episode, and $12,470 ($9,614-$20,657) during the long-term follow-up period; total expenditures averaged $43,598 ($32,577-$58,390) per patient.

Conclusions: The cost of AP requiring hospitalization is high, for the treatment of both acute disease as well as associated long-term complications, which underscores the potential economic benefits from the prevention of this condition.