Original ArticleHospital and ED charges for spina bifida care in the United States between 2006 and 2014: Over $2 billion annually.
Section snippets
Data source
The 2006 to 2014 NIS and NEDS databases from the Healthcare Cost and Utilization Project (HCUP) were used. All analyses utilized HCUP data distributed by CD-ROM or digital download. The NIS approximates a 20-percent stratified sample of all discharges from U.S. community hospitals, excluding rehabilitation and long-term acute care hospitals. Weights are applied to the sample to make national level inferences.10 NEDS approximates a 20% sample of hospital-based EDs in the US. All ED visits are
Demographics
There were 725,646 encounters for individuals with SB identified in NIS and NEDS between 2006 and 2014, with 430,530 (59.3%) being ED encounters (Table 1). The mean age of both inpatient (29 years; 95% CI: 28.3, 29.7) and ED (29 years; 95% CI: 28.6, 29.8) encounters were similar. The rate of females in either setting was approximately 57%. Public insurance (63.2% in NIS vs 66.4% NEDS) was the most common payer type. Q1 (29.3% in NIS vs 30.5% in NEDS) and Q2 (27.3% in NIS vs 28.6% in NEDS) were
Discussion
To our knowledge, this study represents the most comprehensive inpatient and emergency department-based assessment of the economic impact of SB in the United States to date. Dicianno and Wilson (2010) reported a mean inpatient charge of $28,918 and a total sum of $1.08 billion for inpatient admissions in 2005. Our study attempted to build off this finding by documenting the trend of hospital and ED charges over time while also imputing values to improve statistical inference. For our data set,
Conclusion
Based on this inpatient and ER data, hospital charges for management of SB was estimated to be $2.04 billion in 2014 alone in contrast to $1.2 billion in 2006. This figure may be an under-estimate of the economic burden of SB, as it excludes non-ER outpatient SB management and societal costs.
Conflicts of interests
None.
Disclosure
Third World Congress of Spina Bifida in San Diego, CA on March 16, 2017.
Funding source
None.
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