Patient, Payer, and Hospital Characteristics of In-Patient Agranulocytosis in the United States; 1997 and 2005.

Abstract

Objectives: This investigation was to assess the patient, hospital, or payer characteristics of inpatient cases of agranulocytosis from 1997 and 2005 with descriptive statistics. Methods: The retrospective database investigation used the U. S. Department of Health & Human Services, Agency for Healthcare Research and Quality, Healthcare Cost & Utilization Project public use database Nationwide Inpatient Sample (H-CUP NIS) for a principal diagnosis of agranulocytosis. Significance of difference between variables, including standard error (SE), was assessed with a z-test and an alpha level of 0.05. Results: alpha level of 0.05. RESULTS: The mean charges increased from 1997 at $19,670(SE $366) per patient vs. 2005 at $26,866 (SE $813) per patient (p<0.001) while inpatient mortality was not different in 1997 at 718(SE 72) vs. 2005 at 759(SE 69) (p=0.63) and the percentage of patients discharged to home declined from 84.32% [0.85%] in 1997 to 80.12% [1.29%] in 2005 (p=0.007). In 2005, inpatient mortality was lower in teaching hospitals at 1.13%( standard error 0.15%) vs. non teaching hospitals at 2.38%(SE 0.25%) (p<0.001) and for metropolitan areas hospitals at 1.42%(SE 0.14%) vs. non-metropolitan area hospitals at 3.60%(SE 0.68%) (p=0.002). Conclusions: Data from H-CUP NIS indicates higher costs per patient for the primary diagnosis of agranulocytosis in 2005 vs. 1997 while overall inpatient survival is not different and the percentage of patients discharged to home decreased. In 2005 rates of inpatient survival were higher in teaching hospitals than in non-teaching hospitals and hospitals in metropolitan areas than in non-metropolitan areas. These differences were not found in 1997.