School of Medicine and Health Sciences Poster Presentations
A Rare Disease, But a Costly One: The Case of Myasthenia Gravis
Poster Number
270
Document Type
Poster
Publication Date
3-2016
Abstract
Myasthenia gravis (MG) is a chronic, autoimmune neuromuscular disorder affecting fewer than 200,000 individuals in the United States. Disease management is primarily outpatient, but disease exacerbations leading to hospital admission occur in upwards of a third of patients. We sought to determine the inpatient cost of care and assess changes over a 10 year epoch.
Our cohort was identified from the Nationwide Inpatient Sample database for the years 2003 through 2013 using the ICD-9-CM codes. We compared MG to a more common chronic neurological disorder, multiple sclerosis (MS), in which patients also require episodic hospitalizations and to the total US discharges.
Total costs of MG inpatient care costs rose by 13 fold during the study period to $546,834,101. In contrast, MS and all inpatient costs doubled. The increase was largely accounted for by an increase in patient discharges for MG from 870 to 5,353, while MS discharges were close to flat and total discharges dropped. Per discharge costs rose from $48,024 to $98,795 for MG, $16,989 to $32,767 for MS, and $19,666 to 39,462 for all discharges. Length of stay for MG patients increased from 7.4 to 8.0 days while staying flat in the other groups. More discharges were appreciate in the 0-17 year and 85+ year age groups for MG patients in 2013. For MG patients, the percentage with private insurance decreased and number of uninsured MG patients increased in 2013 compared to 2003. Regional variations in cost were appreciated with greater rises in mean charges in the Midwest and South for MG out of proportion to MS and all hospital discharges.
A dramatic rise in hospital discharges for MG has occurred with considerable increase in cost to the health care system. This was largely driven by growth in patient discharges. Our data set does not allow us to identify reasons for this but may reflect an increase in the prevalence of MG, improved identification of patients, or an underlying change in practice patterns.
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Open Access
1
A Rare Disease, But a Costly One: The Case of Myasthenia Gravis
Myasthenia gravis (MG) is a chronic, autoimmune neuromuscular disorder affecting fewer than 200,000 individuals in the United States. Disease management is primarily outpatient, but disease exacerbations leading to hospital admission occur in upwards of a third of patients. We sought to determine the inpatient cost of care and assess changes over a 10 year epoch.
Our cohort was identified from the Nationwide Inpatient Sample database for the years 2003 through 2013 using the ICD-9-CM codes. We compared MG to a more common chronic neurological disorder, multiple sclerosis (MS), in which patients also require episodic hospitalizations and to the total US discharges.
Total costs of MG inpatient care costs rose by 13 fold during the study period to $546,834,101. In contrast, MS and all inpatient costs doubled. The increase was largely accounted for by an increase in patient discharges for MG from 870 to 5,353, while MS discharges were close to flat and total discharges dropped. Per discharge costs rose from $48,024 to $98,795 for MG, $16,989 to $32,767 for MS, and $19,666 to 39,462 for all discharges. Length of stay for MG patients increased from 7.4 to 8.0 days while staying flat in the other groups. More discharges were appreciate in the 0-17 year and 85+ year age groups for MG patients in 2013. For MG patients, the percentage with private insurance decreased and number of uninsured MG patients increased in 2013 compared to 2003. Regional variations in cost were appreciated with greater rises in mean charges in the Midwest and South for MG out of proportion to MS and all hospital discharges.
A dramatic rise in hospital discharges for MG has occurred with considerable increase in cost to the health care system. This was largely driven by growth in patient discharges. Our data set does not allow us to identify reasons for this but may reflect an increase in the prevalence of MG, improved identification of patients, or an underlying change in practice patterns.
Comments
Presented at: GW Research Days 2016