The cost implications of Wilson disease among hospitalized patients: analysis of USA hospitals

Eur J Gastroenterol Hepatol. 2024 Apr 23. doi: 10.1097/MEG.0000000000002777. Online ahead of print.

Abstract

Background and aim: In this study, we used a national cohort of patients with Wilson's disease (WD) to investigate the admissions, mortality rates, and costs over the captured period to assess specific subpopulations at higher burden.

Methods: Patients with WD were selected using 2016-2019 National Inpatient Sample (NIS). The weighted estimates and patient data were stratified using demographics and medical characteristics. Regression curves were graphed to derive goodness-of-fit for each trend from which R2 and P values were calculated.

Results: Annual total admissions per 100 000 hospitalizations due to WD were 1075, 1180, 1140, and 1330 (R2 = 0.75; P = 0.13) from 2016 to 2019. Within the demographics, there was an increase in admissions among patients greater than 65 years of age (R2 = 0.90; P = 0.05) and White patients (R2 = 0.97; P = 0.02). Assessing WD-related mortality rates, there was an increase in the mortality rate among those in the first quartile of income (R2 = 1.00; P < 0.001). The total cost for WD-related hospitalizations was $20.90, $27.23, $24.20, and $27.25 million US dollars for the years 2016, 2017, 2018, and 2019, respectively (R2 = 0.47; P = 0.32). There was an increasing total cost trend for Asian or Pacific Islander patients (R2 = 0.90; P = 0.05). Interestingly, patients with cirrhosis demonstrated a decreased trend in the total costs (R2 = 0.97; P = 0.02).

Conclusion: Our study demonstrated that certain ethnicity groups, income classes and comorbidities had increased admissions or costs among patients admitted with WD.