Cost of Specific Emergency General Surgery Diseases and Factors Associated with High Cost XXXX .

@entity1 @entity0 @entity5 @entity7823 @entity764 @entity14 @entity490 @entity130
BACKGROUND: We have previously shown that overall cost of hospitalization for Emergency General Surgery (EGS) diseases is over  28 billion annually and rising. The purpose of this study was to estimate the costs associated with specific @entity7823 and identify factors associated with high cost hospitalizations. METHODS: The American Association for the Surgery of @entity130 definition was used to identify hospitalizations of adult EGS @entity1 in the 2010 National Inpatient Sample (NIS) data. Cost of each hospitalization was obtained utilizing cost-to-charge ratio in NIS. Regression analysis was used to estimate cost for each EGS disease adjusted for @entity1 and hospital characteristics. Hospitalizations with cost exceeding 75th percentile for each EGS disease were compared to lower cost hospitalizations to identify factors associated with high cost. RESULTS: Thirty-one @entity7823 resulted in 2,602,074 hospitalizations nationwide in 2010 at an average adjusted cost of  10,110 (95% CI =  10,086 to  10,134) per hospitalization. Of these, only nine diseases constituted 80% of the total volume and 74% of the total cost. @entity764 , @entity14 , and small intestine @entity5 were the most expensive @entity7823 with adjusted mean cost per hospitalization exceeding  20,000, while @entity0 , @entity490 , and soft tissue infection were the least expensive, with mean adjusted costs less than  7,000 per hospitalization. Most important factors associated with high cost hospitalizations was the number and type of procedures performed (76.2% of variance), but a region in Western United States (11.3%), Medicare and Medicaid payors (2.6%), and hospital ownership by public or not-for-profit entities (5.6%) were also associated with high cost hospitalizations. CONCLUSIONS: A small number of diseases constitute a vast majority of EGS hospitalizations and their cost. Attempts at reducing the cost of EGS hospitalization will require controlling the cost of procedures. LEVEL OF EVIDENCE: III.
