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Page 41
Journal of Skin
September 18-20, 2017 SAN ANTONIO, TX, USA
World Dermatological Congress
Dermatology Congress 2017
The in-hospital financial burdenof hidradenitis suppurativa inpatientswith inflammatory
bowel disease
Alvaro J Ramos-Rodriguez, Ali Khan, Lauren Bonomo, Dmitriy Timerman, Yiming Luo and Alejandro Lemor
Icahn School of Medicine at Mount Sinai West, USA
Background: Hidradenitis suppurativa (HS), formerly known as acne in versa, is a chronic inflammatory
and debilitating disease that significantly affects the patient’s quality of life. There is a high prevalence of HS
in patients with inflammatory bowel disease (IBD), which further compromises quality of life in this patient
population. In this study, we sought to explore the in-hospital financial burden of HS in patients with IBD given
the lack of published literature on this topic.
Methods: This was a retrospective cohort study using the National Inpatient Sample (NIS) for the years 2008
through 2014. All patients with ICD-9 CM codes for any diagnosis of Inflammatory Bowel Disease (IBD) from
2008 to 2014 across the US were included. There were no exclusion criteria. Patients with IBD were classified
as having hidradenitis suppurativa (HS) and not having HS using ICD-9 CM code 705.83. The primary outcome
was the financial burden of HS on patients with IBD. The financial burden was measured by resource utilization
which included median hospital length of stay (LOS), imaging and bedside procedures (i.e., abdominal CT-
scan, incision and drainage) and mean hospitalization costs. Data of patient’s insurance and disposition was also
collected.
Results: A total of 3,079,332 admissions with inflammatory bowel disease (IBD) were included in the study,
of which 4,369 had a diagnosis of hidradenitis suppurativa (HS). Patients with HS-IBD displayed increased
additional hospital length of stay when compared to IBD patients without HS (4 days vs 5 days, p<0.001). Patients
with IBD-HS incurred significantly higher additional total hospital costs when compared to IBD patients without
HS (Mean additional costs: $ 1,035, p=0.013). There was no difference in additional imaging (i.e. abdominal
CT-scan) between the two groups. Patients with IBD-HS had significantly more incision and drainage procedures
than those without HS (0.7% vs 10.8%, p<0.001). Additionally, more patients with IBD-HS had Medicare and
Medicaid insurance compared to those without HS (61% vs 47.7%, p<0.001).
Conclusion: We conclude that there is a significant increase in-hospital financial burden in IBD patients with
hidradenitis suppurativa compared to those with IBD only. Patients with IBD-HS had increased resource utilization
including hospital length of stay, mean total hospitalization costs and bedside procedures. More patients with
IBD-HS had lower household income and were insured by Medicare and Medicaid.