Economic Burden Associated with Hospitalization for Radiation Cystitis: Results from a Statewide Inpatient Database

Radiation cystitis is associated with a significant burden to patients and the health care system. However, the regional burden of treatment and its associated costs remains poorly described. We assessed the health care costs and need for intervention among patients admitted to the hospital with radiation cystitis.

Using data from the Ohio Hospital Association we identified patients admitted with a diagnosis of radiation cystitis from 2009 to 2013. The primary outcome was the adjusted inpatient cost (adjusted to 2013 U.S. dollars) associated with in-hospital treatment of radiation cystitis. Secondary outcomes included percentage of patients requiring endoscopic urological procedures, blood transfusions and nephrostomy tubes. We used a generalized estimating equation model to determine in-hospital costs. Multivariate logistic regression analyses were used to determine factors associated with requiring an invasive procedure.

We identified 1,111 patients admitted to Ohio hospitals between 2009 and 2013 with a diagnosis of radiation cystitis. Mean patient age (±SD) was 73.9 (±12.5) years. Median length of stay was 4 days (IQR 3-8). The adjusted median cost of hospitalization per admission in 2013 for these patients was $7,151 (IQR $4,251-$16,569). Overall 28.9% of patients required blood transfusions, 34.4% required endourological procedures and 3.4% required nephrostomy tubes. The odds of undergoing an invasive procedure were associated with increasing length of stay, need for blood transfusion and male gender.

This study is the first population based study to our knowledge to assess the treatment burden and health care costs from radiation cystitis. A diagnosis of radiation cystitis carries with it a significant economic and treatment associated burden.