An Exploratory Analysis of Healthcare Utilization and Costs in Pediatric Crohnʼs Disease

Purpose: To evaluate healthcare utilization costs associated with pediatric Crohn's disease (PCD) from a payor perspective. Methods: An analysis using data from 2003 through 2006 containing claims for HMO pts assigned to HealthCare Partners Medical Group from 6 commercial health plans in S. CA was conducted. Newly diagnosed pts age <18 with Crohn's disease (CD; ICD-9 555.×) were identified. Pts were required to have 6-mos pre- and 12-mos post continuous eligibility from their disease index date. Cost and resource utilization were compared to a cohort without CD who were matched to the pts with PCD on age, sex, and birthday (within 30 days of age/sex matched pts with PCD). Statistical significance was not assessed due to the small sample size. Results: 62 pts with PCD were identified, with 30 meeting the continuous eligibility criteria. Most were female (56.7%) and the median age at dx was 13 yrs. The comparator grp consisted of 10,864 children. The total per member per month (PMPM) cost for pts with PCD was $2,547.32, with 70% attributable to PCD, vs a PMPM cost of $166.07 for the non-PCD cohort. There were 500 admissions per 1,000 members per yr (PTMPY) for the PCD grp vs 11.2 for the comparator cohort. The average length of stay (ALOS) was also longer for the PCD cohort (7.6 days vs 4.4 days). The PMPM cost of inpt stays was $1,409.41 for the PCD cohort vs $18.16 for the comparator cohort. Conclusion: PCD is associated with much higher levels of resource utilization and costs of care, primarily driven by inpt stays. Treating PCD appropriately before the disease progresses to a level requiring hospitalization may help reduce some of the costs in PCD.Table