Acute pancreatitis – costs for healthcare and loss of production

Abstract

OBJECTIVE. Severity of acute pancreatitis (AP) can vary from a mild to a fulminant disease with high morbidity and mortality. Cost analysis has, however, hitherto been sparse. The aim of this study was to calculate the cost of acute pancreatitis, both including hospital costs and costs due to loss of production. MATERIAL AND METHODS. All adult patients treated at Skane University Hospital, Lund, during 2009-2010, were included. A severity grading was conducted and cost analysis was performed on an individual basis. RESULTS. Two hundred and fifty-two patients with altogether 307 admissions were identified. Mean age was 60 ± 19 years, and 121 patients (48%) were men. Severe AP (SAP) was diagnosed in 38 patients (12%). Thirteen patients (5%) died. Acute biliary pancreatitis was more costly than alcohol induced AP (p < 0.001). Total costs for treating mild AP (MAP) in patients ≤65 years old was lower (p = 0.001) and costs for SAP was higher (p = 0.024), as compared to older patients. The overall hospital cost and cost for loss of production was per person in mean €5,100 ± 2,400 for MAP and €28,200 ± 38,100 for SAP (p < 0.001). The costs for treating AP during the two-year-long study period were in mean €9,762 ± 19,778 per patient. Extrapolated to a national perspective, the annual financial burden for AP in Sweden would be €38,500,000; corresponding to €4,100,000 per million inhabitants. CONCLUSIONS. The costs of treating AP are high, especially in severe cases with a long ICU stay. These results highlight the need to optimize care and continue the identification and focus on SAP, in order to try to limit organ failure and infectious complications.

Acute pancreatitis: confronting to improve

“…As for economic data, in all three OUs, costs were lower than those reported in literature, [13][14][15] with a prevalence of costs for therapeutic resources in Emergency Medicine and for diagnostic resources in the Medical Ward of Cattolica and Colleferro.…”

“…In all OUs, costs are lower than reported in literature (about 10,000 € per patient); [13][14][15] however, it is observed a large variability range (the overall average direct cost for patient with AP varies from € 1123.32 of Cattolica to € 1610.59 in Colleferro, and € 1825.82 in Catanzaro, where the average age is lower, but there are multiple comorbidities).…”

“…[13][14][15] Undoubtedly, the diversification of health care depending on the characteristics of patients seemed mandatory, considering the two basic variables to keep monitored in each nursing model: the clinical complexity and the nursing complexity of patients, variables that do not always coincide.…”

Readmissions due to acute biliary edematous pancreatitis in patients without cholecystectomy

“…In Japan, Murata et al highlighted that the factors that increase admission costs of patients with acute pancreatitis are complex treatments such as necrosectomy or intensive care in case of severe pancreatitis (23). At present, due to the scarce number of studies about associated costs (21) there are few data concerning expenses arising from early or delayed cholecystectomy, and there are no studies that include the loss of work days in the costs (11). A retrospective study done in one center showed that cholecystectomy performed within the first two weeks does not increase costs as compared to late cholecystectomy (24).…”

“…Most of the expenses are due to hospitalization but the cost of the loss of work days adds an unnecessary economic burden that should be taken into account (21).…”