Observational Study
Copyright ©The Author(s) 2017. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Gastroenterol. Jun 28, 2017; 23(24): 4428-4436
Published online Jun 28, 2017. doi: 10.3748/wjg.v23.i24.4428
Healthcare utilization and costs associated with gastroparesis
Vaibhav Wadhwa, Dhruv Mehta, Yash Jobanputra, Rocio Lopez, Prashanthi N Thota, Madhusudhan R Sanaka
Vaibhav Wadhwa, Department of Internal Medicine, Fairview Hospital, Cleveland Clinic, Cleveland, OH 44111, United States
Dhruv Mehta, Department of Internal Medicine, Westchester Medical Center, Valhalla, NY 10595, United States
Yash Jobanputra, Rocio Lopez, Prashanthi N Thota, Madhusudhan R Sanaka, Department of Gastroenterology and Hepatology, Digestive Disease Institute, Cleveland Clinic, Cleveland, OH 44106, United States
Madhusudhan R Sanaka, Center for Advanced Endoscopy, Digestive Disease Institute, Cleveland Clinic, Cleveland, OH 44106, United States
Author contributions: Wadhwa V, Mehta D, Thota PN and Sanaka MR contributed to study concept and design; Wadhwa V, Mehta D, Jobanputra Y and Lopez R contributed to acquisition of data, analysis and interpretation of data; all authors drafted of the manuscript; Sanaka MR critically revised the manuscript.
Conflict-of-interest statement: None of the authors have any potential conflicts relevant to the manuscript.
Data sharing statement: Not applicable. Data available on hcupnet.ahrq.gov for use.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Correspondence to: Madhusudhan R Sanaka, MD, FACG, FASGE, Medical Director, Center for Advanced Endoscopy, Digestive Disease Institute, Cleveland Clinic, 9500 Euclid Avenue, Cleveland, OH 44106, United States. sanakam@ccf.org
Telephone: +1-216-4445404 Fax: +1-216-4446284
Received: December 19, 2016
Peer-review started: December 20, 2016
First decision: January 19, 2017
Revised: February 23, 2017
Accepted: June 1, 2017
Article in press: June 1, 2017
Published online: June 28, 2017

To use a national database of United States hospitals to evaluate the incidence and costs of hospital admissions associated with gastroparesis.


We analyzed the National Inpatient Sample Database (NIS) for all patients in whom gastroparesis (ICD-9 code: 536.3) was the principal discharge diagnosis during the period, 1997-2013. The NIS is the largest publicly available all-payer inpatient care database in the United States. It contains data from approximately eight million hospital stays each year. The statistical significance of the difference in the number of hospital discharges, length of stay and hospital costs over the study period was determined by regression analysis.


In 1997, there were 3978 admissions with a principal discharge diagnosis of gastroparesis as compared to 16460 in 2013 (P < 0.01). The mean length of stay for gastroparesis decreased by 20 % between 1997 and 2013 from 6.4 d to 5.1 d (P < 0.001). However, during this period the mean hospital charges increased significantly by 159 % from $13350 (after inflation adjustment) per patient in 1997 to $34585 per patient in 2013 (P < 0.001). The aggregate charges (i.e., “national bill”) for gastroparesis increased exponentially by 1026 % from $50456642 ± 4662620 in 1997 to $568417666 ± 22374060 in 2013 (P < 0.001). The percentage of national bill for gastroparesis discharges (national bill for gastroparesis/total national bill) has also increased over the last 16 years (0.0013% in 1997 vs 0.004% in 2013). During the study period, women had a higher frequency of gastroparesis discharges when compared to men (1.39/10000 vs 0.9/10000 in 1997 and 5.8/10000 vs 3/10000 in 2013). There was a 6-fold increase in the discharge diagnosis of gastroparesis amongst type 1 DM and 3.7-fold increase amongst type 2 DM patients over the study period (P < 0.001).


The number of inpatient admissions for gastroparesis and associated costs have increased significantly over the last 16 years. Inpatient costs associated with gastroparesis contribute significantly to the national healthcare bill. Further research on cost-effective evaluation and management of gastroparesis is required.

Keywords: Inpatient admission rates, Gastroparesis, Cancer epidemiology, National inpatient database

Core tip: Gastroparesis is a debilitating condition which ranges in severity from minimal to severe symptoms requiring prolonged hospitalization and interventions. There is limited data on rates and costs associated with gastroparesis admissions. Our study found 4-fold increase in gastroparesis discharges over the study period and significant increases in gastroparesis discharges related to diabetes type 1 and type 2.