OBJECTIVES:

To compare trends in hospital length of stay, total costs and comorbidities in Rheumatoid Arthritis (RA), Crohn’s Disease (CD) and Ulcerative Colitis (CD) patients insured by Medicaid.

METHODS: The 2016 National Inpatient Sample (NIS) data set from the Healthcare Cost and Utilization Project was utilized in order to determine the number of hospital admissions for Medicaid patients with RA, UC and CD. Propensity score matched analysis was conducted to compare hospital LOS and costs in selected patients. Thirty comorbidities were assessed using Elixhauser scoring. Multivariate logistic regression was conducted to assess predictor variables for LOS and costs.

RESULTS:

In 2016, for patients insured by Medicaid, there were an estimated 36355, 16520 and 48335 hospitalizations with a diagnosis of CD, UC and RA, respectively. The mean age was significantly higher for RA compared to UC and CD (50.88 [SD 12.55] versus 37.41 [SD 13.64] and 38.44 [SD 15.58] years, respectively). The percentage female was significantly higher in RA (77%) versus CD (59%) and RA (55%). The hospital LOS was slightly higher for UC patients compared to CD and RA patients (6.24 [SD 11.15] versus 5.59 [SD 8.52] and 5.47 [SD 8.57] days, respectively). Similarly, the total hospital charges were slightly higher for UC versus CD and RA patients (Mean $61790 versus $47387 and $53814, respectively). Some comorbidities significantly varied across three groups: Chronic Pulmonary Disease (20%, 17%, 39%), Hypertension (21%, 23%, 45%) Obesity (11%, 10%, 22%), in CD, UC and RA patients, respectively. The comorbidity score was almost double in RA compared to UC and CD (Mean 4.47 versus 2.29 and 2.38, respectively).

CONCLUSIONS: Medicaid patients with CD, UC and RA pose a high burden of hospitalizations. Patients differ significantly by gender and varying rate of comorbidities. RA patients had relatively more comorbidities compared to UC and CD.