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Number and cost of hospitalizations with principal and secondary diagnoses of tuberculosis, United States
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December 01 2018
Source: Int J Tuberc Lung Dis. 22(12):1495-1504 -
Alternative Title:Int J Tuberc Lung Dis
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Personal Author:
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Description:OBJECTIVE :
To estimate the number and cost of hospitalizations with a diagnosis of active tuberculosis (TB) disease in the United States.
METHODS:
We analyzed the 2014 National In-Patient Sample using the International Classification of Diseases, Ninth Revision, Clinical Modification (ICD-9) codes to identify hospitalizations with a principal (TB-PD) or any secondary discharge (TB-SD) TB diagnosis. We used a generalized linear model with log link and gamma distribution to estimate the cost per TB-PD and TB-SD episode adjusted for patient demographics, insurer, clinical elements, and hospital characteristics.
RESULTS:
We estimated 4985 TB-PD and 6080 TB-SD hospitalizations nationwide. TB-PD adjusted averaged $16695 per episode (95%CI $16168–$17221). The average for miliary/disseminated TB ($22498, 95%CI $21067–$23929) or TB of the central nervous system ($28338, 95%CI $25836–$30840) was significantly greater than for pulmonary TB ($14819, 95%CI $14284–$15354). The most common principal diagnoses for TB-SD were septicemia (n=965 hospitalizations), human immunodeficiency virus infection (n = 610), pneumonia (n=565), and chronic obstructive pulmonary disease and bronchiectasis (COPD-B, n = 150). The adjusted average cost per TB-SD episode was $15909 (95%CI $15337–$16481), varying between $8687 (95%CI $8337–$9036) for COPD-B and $23335 (95%CI $21979–$24690) for septicemia. TB-PD cost the US health care system $123.4 million (95%CI $106.3–$140.5) and TB-SD cost $141.9 million ($128.4–$155.5), of which Medicaid/Medicare covered respectively 67.2% and 69.7%.
CONCLUSIONS:
TB hospitalizations result in substantial costs within the US health care system.
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Pubmed ID:30606323
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Pubmed Central ID:PMC8050949
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