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1
Knight Cardiovascular Institute, Oregon Health & Science University, Portland, OR 97239, USA.
2
Albany Medical College, Albany, NY 12208, USA.
3
Takeda Pharmaceuticals U.S.A., Inc., Cambridge, MA 02139, USA.
4
RTI Health Solutions, Research Triangle Park, NC 27709, USA.
5
Takeda Pharmaceuticals U.S.A., Inc., Lexington, MA 02420, USA.
1
Knight Cardiovascular Institute, Oregon Health & Science University, Portland, OR 97239, USA.
2
Albany Medical College, Albany, NY 12208, USA.
3
Takeda Pharmaceuticals U.S.A., Inc., Cambridge, MA 02139, USA.
4
RTI Health Solutions, Research Triangle Park, NC 27709, USA.
5
Takeda Pharmaceuticals U.S.A., Inc., Lexington, MA 02420, USA.
Hypoparathyroidism (HypoPT) is a rare disease associated with high morbidity. Its economic impact is not well understood. This retrospective, cross-sectional study used data from the United States-based National Inpatient Sample and the Nationwide Emergency Department Sample from 2010 to 2018 to quantify overall trends in number, cost, charges, and length of stay (LOS) for inpatient hospitalizations and number and charges for emergency department (ED) visits for HypoPT-related and for non-HypoPT-related causes. Additionally, the study estimated the marginal effect of HypoPT on total inpatient hospitalization costs and LOS as well as ED visit charges. Over the observed period, a mean of 56.8-66.6 HypoPT-related hospitalizations and 14.6-19.5 HypoPT-related ED visits were recorded per 100 000 visits per year. Over this period, the rate of HypoPT-related inpatient hospitalizations and ED visits increased by 13.5% and 33.6%, respectively. The mean LOS for HypoPT-related hospitalizations was consistently higher than for non-HypoPT-related causes. Total annual HypoPT-related inpatient hospitalization costs increased by 33.6%, and ED visit charges increased by 96.3%. During the same period, the annual costs for non-HypoPT-related hospitalizations and charges for ED visits increased by 5.2% and 80.3%, respectively. In all years, HypoPT-related hospital encounters resulted in higher charges and costs per individual visit than non-HypoPT-related encounters. The marginal effect of HypoPT on inpatient hospitalization costs and LOS, and on ED charges, increased over the period of observation. This study demonstrated that HypoPT was associated with substantial and increasing healthcare utilization in the United States between 2010 and 2018.
Rate of (A) HypoPT-related inpatient hospitalizations and (B) ED visits. Overall percentage change from 2010 to 2018: (A) 13.5%; (B) 33.6%. Percentages were calculated based on raw values. Brackets indicate decrease in percentage. Abbreviations: ED, emergency department; HypoPT, hypoparathyroidism; ICD-10-CM, International Classification of Diseases, 10th Revision, Clinical Modification.
Rate of non-HypoPT-related (A) inpatient hospitalizations and (B) ED visits. Overall percentage change from 2010 to 2018: <0.01% for (A) and (B). Abbreviations: ED, emergency department; HypoPT, hypoparathyroidism; ICD-10-CM, International Classification of Diseases, 10th Revision, Clinical Modification.
Mean length of HypoPT-related and non-HypoPT-related inpatient hospitalization per visit in (A) unmatched and (B) matched cohorts. Matching was performed based on age, sex, race, elective vs non-elective admission (NIS only), vital status at discharge, primary expected payer, median household income, national quartile for patient ZIP code, hospital region, hospital size based on bed numbers (NIS only), control/ownership of hospital, and location and teaching status of the hospital.
a
Switch to ICD-10-CM coding system. Abbreviations: HypoPT, hypoparathyroidism; ICD-10-CM, International Classification of Diseases, 10th Revision, Clinical Modification; NIS, National Inpatient Sample.
Marginal effect of HypoPT on length of stay for inpatient hospitalization, compared with no HypoPT, by year. Overall percentage change from 2010 to 2018: 11.1%. Percentages were calculated based on raw values. Brackets indicate decrease in percentage. Abbreviations: HypoPT, hypoparathyroidism; ICD-10-CM, International Classification of Diseases, 10th Revision, Clinical Modification.
Weighted total sum in US dollars for (A) HypoPT-related and (B) non-HypoPT-related inpatient hospitalizations, and (C) HypoPT-related and (D) non-HypoPT-related ED visits. Percentages were calculated based on raw values. Brackets indicate decrease in percentage. Abbreviations: B, billion; ED, emergency department; HypoPT, hypoparathyroidism; ICD-10-CM, International Classification of Diseases, 10th Revision, Clinical Modification; M, million.
Mean inpatient hospitalization costs in US dollars in (A) matched and (B) unmatched cohorts and mean ED visit charges in (C) matched and (D) unmatched cohorts per event in HypoPT-related and non-HypoPT-related events. Matching was performed based on age, sex, race, elective vs nonelective admission (NIS only), vital status at discharge, primary expected payer, median household income, national quartile for patient ZIP code, hospital region, hospital size based on bed numbers (NIS only), control/ownership of hospital, and location and teaching status of the hospital.
a
Switch to ICD-10-CM coding system. Abbreviations: ED, emergency department; HypoPT, hypoparathyroidism; ICD-10-CM, International Classification of Diseases, 10th Revision, Clinical Modification; NIS, National Inpatient Sample.
Marginal effect of HypoPT on (A) inpatient hospitalization costs and (B) ED visit charges by year compared with non-HypoPT-related events. Overall percentage change from 2010 to 2018: (A) 45.8%; (B) 26.9%. Brackets indicate decrease in percentage. Abbreviations: ED, emergency department; HypoPT, hypoparathyroidism; ICD-10-CM, International Classification of Diseases, 10th Revision, Clinical Modification.
Sood A, et al.
J Pediatr Urol. 2015 Oct;11(5):246.e1-8. doi: 10.1016/j.jpurol.2014.10.005. Epub 2015 Feb 7.
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Hu T, et al.
J Med Econ. 2024 Jan-Dec;27(1):324-336. doi: 10.1080/13696998.2024.2314429. Epub 2024 Feb 22.
J Med Econ. 2024.
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Singh JA, et al.
Respir Res. 2016 Jan 6;17:1. doi: 10.1186/s12931-015-0319-y.
Respir Res. 2016.
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Free PMC article.
Ross TD, et al.
J Arthroplasty. 2020 Feb;35(2):364-370. doi: 10.1016/j.arth.2019.09.015. Epub 2019 Sep 14.
J Arthroplasty. 2020.
PMID:
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Review.
Moore BJ, et al.
2020 Dec 8. In: Healthcare Cost and Utilization Project (HCUP) Statistical Briefs [Internet]. Rockville (MD): Agency for Healthcare Research and Quality (US); 2006 Feb–. Statistical Brief #268.
2020 Dec 8. In: Healthcare Cost and Utilization Project (HCUP) Statistical Briefs [Internet]. Rockville (MD): Agency for Healthcare Research and Quality (US); 2006 Feb–. Statistical Brief #268.
PMID:
33439600
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