OBJECTIVES: To examine trends in hospital length of stay and total costs in patients with alpha-1 antitrypsin deficiency.

METHODS: The latest available 2015 National Inpatient Sample (NIS) data set of hospital admissions from the Healthcare Cost and Utilization Project was utilized in order to determine the number of hospital admissions for patients with AAT deficiency (identified by ICD-9 for Q1-Q3 and ICD-10 codes for Q4). The LOS and costs were compared by payer type, race and age groups.

RESULTS: Based on our inclusion criteria we found 1,493 admissions, representing 0.017% of all hospitalizations. The mean age was 56.37 years (SD: 15.61, Median 57 years). The overall mean LOS was 5.43 days (SD: 5.27, Median 4 days). Majority of the hospitalizations were in patients age 60+ (43%), followed by age 45-59 (39%). Mean (SD) LOS by age: 0-18: 0-18: 8 days (SD: 13, n= 27), 18-45: 4.35 days (SD: 4.22, n= 174), 45-59: 5.63 days (SD: 5.23, n= 433), 60+: 5.44 days (SD: 4.68, n= 486).

The mean LOS by payer: Medicare: 5.42 days (SD: 4.49), Medicaid: 6.07 days (SD: 7.77), Private: 5.22 days (SD: 5.37). The overall mean charges were $50,612 (SD: $80902). The mean costs by age group were 0-18: $120,026 (SD: $226312), 18-45: $39,192 (SD: $68760), 45-59: $53,118 (SD: $81175), 60+: $48,613 (SD: $66897). The mean costs by payer type were: Medicare: $45588 (SD: $61111), Medicaid: $54604 (SD: $107560), Private: $53702 (SD: $86512). There were no significant differences in LOS and charges by gender. For race, the sample size was too small to make any comparisons.

CONCLUSIONS: Patients with alpha-1 antitrypsin deficiency incur some costs for public and private payers due to the need for hospitalization. While costs are moderate, the long length of stay poses significant burden on hospitals. Newer more effective treatments are needed to lower the LOS for hospitals.