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Practice patterns and costs of hospitalization for upper gastrointestinal hemorrhage
J M Richter1, T C Wang, K Fawaz
1Medical Service, Massachusetts General Hospital, Boston 02114.
Insights
This study found similar medical management and low costs for noncirrhotic upper gastrointestinal bleeding across three Boston hospitals. Resource utilization and patient outcomes were consistent, highlighting efficient care patterns.
Area of Science:
- Gastroenterology
- Health Services Research
- Medical Economics
Background:
- Noncirrhotic upper gastrointestinal bleeding is a common medical condition requiring significant healthcare resources.
- Understanding practice patterns and associated costs is crucial for optimizing patient care and resource allocation.
Purpose of the Study:
- To examine practice patterns and costs associated with the medical management of noncirrhotic upper gastrointestinal bleeding.
- To compare management strategies and resource utilization across three distinct hospital settings.
Main Methods:
- An observational study was conducted involving 111 patients with noncirrhotic upper gastrointestinal bleeding across three Boston hospitals.
- Data on patient management, procedures, and hospitalization costs were collected and analyzed.
- The New England Medical Center cost model was used to determine direct hospitalization costs.
Main Results:
- No significant differences in patient management were observed, with minor variations in radiography and cimetidine use.
- Surgical intervention was infrequent (3-7%), and overall mortality was low (0-8%).
- The average direct hospitalization cost was $3,180, primarily driven by hospital stay (63%) and blood transfusions (14%).
Conclusions:
- Practice patterns and resource utilization for noncirrhotic upper gastrointestinal bleeding are highly similar across different hospitals.
- Hospitalization costs are substantial but largely attributable to essential services like bed stay and transfusions.
- The study provides valuable data on the economic aspects of managing this condition, supporting efficient healthcare delivery.
Abstract:
We conducted an observational study at three hospitals in Boston to examine the patterns of practice and the costs involved in the medical management of noncirrhotic, upper gastrointestinal bleeding. A total of 111 patients were identified and studied: 42 from hospital 1, 38 from hospital 2, and 31 from hospital 3. There were no significant differences in the management of the patients, except for the more frequent use of upper gastrointestinal radiography at hospital 3 and the more frequent use of cimetidine at hospital 2. Only a small percentage (3-7%) of patients required surgery, and overall mortality (0-8%) was low. The average cost of hospitalization, determined by using the New England Medical Center cost model, was calculated for direct costs ($3,180). The majority of costs incurred were for hospital bed or intensive care unit stay (63%) and transfusion of blood products (14%), with costs for physicians' services (9%), endoscopy (2%), and upper gastrointestinal radiography (1%) accounting for only a small percentage. This study demonstrates remarkable similarity in practice patterns and resource utilization at three different hospitals and provides data on the actual costs involved in hospitalization for noncirrhotic, upper gastrointestinal hemorrhage.