Estimating the Economic Burden of Diarrhea in the United States Amongst the Privately Insured In-Patient Population Público
Kernohan, Alison Renee (2011)
Published
Abstract
Background:
While several studies have quantified the economic burden of
diarrheal disease in the
pediatric population, recent payment-based estimates for the U.S.
population are rare and
often limited to a particular diarrheal illness.
Objective:
This study used the MarketScan Commercial Claims and Encounters
database to estimate
the economic burden of hospitalizations due to diarrheal disease in
the privately insured
population between the ages of 0 and 64.
Methods:
The sample population was isolated from the larger database using
ICD-9 codes of
interest. Costs were then calculated for in-patient records
hospitalized for diarrheal and
delineated into two groups: those who had a diagnosis of interest
coded as their primary
diagnosis and those who had a diagnosis of interest listed as a
secondary diagnosis.
Additional analyses were conducted to determine the effect of
immunocompromised
status on costs, age, gender and region specific rates of
hospitalization, seasonality and
length of stay.
Results:
Between 2004 and 2008 the average cost per episode was $7,926 for
patients with a
primary diagnosis of diarrhea (including $7,266 in insurer payments
and $660 in out of
pocket payments) and $15,541 for patients with a secondary
diagnosis of diarrhea
(including $14,680 in insurer payments and $862 in out of pocket
payments). Cost also
varied significantly depending on whether the patient was
immunocompromised or
immunocompetent. Rates of diarrheal illness increased with age,
were higher in females
over males and were highest in the South as compared to other
regions.
Discussion:
While diarrheal illness is predominately a self-limiting illness,
people are still being
hospitalized for treatment, significantly contributing to the
domestic economic burden of
diarrheal disease. Further research is needed to quantify the cost
of those over the age of
64, and cases of diarrhea that are never hospitalized.
Table of Contents
TABLE OF CONTENTS
I. INTRODUCTION
........................................................................................................1
Current Economic Estimates
........................................................................................1
II. MATERIALS AND METHODS
.................................................................................2
Data source
..................................................................................................................2
Inclusion Criteria
.........................................................................................................3
Cost Calculation Methodology
.....................................................................................3
Secondary Analyses
.....................................................................................................4
III. RESULTS
.................................................................................................................6
Economic
Estimates.....................................................................................................6
Population Demographics
............................................................................................8
Seasonality
................................................................................................................
10
Immunocompromised
Patients
...................................................................................
12
IV. DISCUSSION
.........................................................................................................
13
Limitations
................................................................................................................
17
V. CONCLUSION
........................................................................................................
18
WORKS CITED
............................................................................................................
19
APPENDIX A:
..............................................................................................................
21
APPENDIX B:
..............................................................................................................
23
APPENDIX C:
..............................................................................................................
24
LIST OF TABLES AND FIGURES
Mean costs per case for privately insured in-patient diarrheal
cases
between 2004-2008
.........................................................................................................6
Length of Stay for a case of diarrhea within the United
States
between 2004-2008
........................................................................................................7
Cost per case estimates for in-patient records with a primary
diagnosis
of diarrhea by
year.............................................................................................................8
Specific rates of hospitalizations primarily from diarrheal
disease
between the years
2004-2008........................................................................................9
Rates of hospitalizations for diarrheal disease between the
years
2004-2008.........................................................................................................................10
Mean hospital admissions involving any diagnosis of diarrhea per
day
by month of admission,
2004-2008..................................................................................10
Mean hospital admissions involving a primary diagnosis of diarrhea
per
day by month of admission,
2004-2008........................................................................11
Seasonality of in-patient records of diarrheal disease by average
cases
per day for
2004-2008..................................................................................................11
Mean costs per case for hospitalized patients with a primary
or
secondary diagnosis of diarrhea by immune status,
2004-2008...................................12
Two-sample T-tests results for immunocompromised and
immunocompetent
patients with a primary or secondary diarrheal diagnosis between
2004-2008........13
APPENDICES
Health insurance status for the United States
population..................................................23
Major Diagnostic Category for the sample
population.....................................................25
Net Payment from
Insurer................................................................................................26
Deductable Payments from
Patient....................................................................................27
Copayments made by the
patient.......................................................................................27
Coinsurance Payments made by the
patient.......................................................................27
Certificate of Benefits and other savings to the
insurer.....................................................27
Total gross
cost..................................................................................................................28
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