Published online Jun 28, 2017. doi: 10.3748/wjg.v23.i24.4428
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
Processing time: 188 Days and 23.6 Hours
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.
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.