Cost analysis of inpatient treatment of anorexia nervosa in adolescents: hospital and caregiver perspectives

Alene Toulany; Matthew Wong; Debra K. Katzman; Nadia Akseer; Cathleen Steinegger; Rebecca L. Hancock-Howard; Peter C. Coyte

doi:10.9778/cmajo.20140086

Article Figures & Tables

Tables

View popup

Table 1: Characteristics of study cohort (n = 73)

Characteristic	No. (%) of patients*
Age, yr, mean ± SD (median, range)	15.2 ± 1.6 (15.4, 12.0–17.6)
Female sex	65 (89)
Comorbid medical diagnosis at admission	22 (30)
Comorbid psychiatric diagnosis at admission	25 (34)
Admitted directly from emergency department	64 (88)
BMI at admission, kg/m², mean ± SD (median, range)	16.4 ± 2.5 (16.1, 11.3–26.2)
Duration of symptoms, wk, mean ± SD (median, range)	55.8 ± 59.9 (41.6, 4.4–362.9)
Length of stay, d, mean ± SD (median, range)	37.9 ± 19.7 (35, 9–153)
Household income by postal code, CAD, mean ± SD (median, range)	83 752 ± 33 415 (82 795, 30 979–207 589)
Distance travelled between home and hospital, km, mean ± SD (median, range)	39.6 ± 33.4 (31.8, 2.7–134.0)

Note: BMI = body mass index, CAD = Canadian dollars, SD = standard deviation. *Unless otherwise indicated.

View popup

Table 2: Estimates of total hospital and caregiver costs

Variable	Total cost,* $
Variable	Mean ± SD	Median (range)
Hospital cost	51 349 ± 26 598	47 304 (15 790–194 618)
Caregiver cost	3 583 ± 1 904	3 146 (673–11 119)
Lost work productivity	766 ± 389	673 (93–2 080)
Lost leisure time	2 817 ± 1 588	2 565 (531–9 039)
Societal cost†	54 932 ± 27 864	49 807 (16 488–201 036)

*In 2013 Canadian dollars (US$1 = Can$1.03 in 2013). †Sum of hospital and caregiver costs.

View popup

Table 3: Multivariate linear regression model for hospital costs per admission to hospital for anorexia nervosa in adolescent patients

Predictor variable	Logarithmic cost model (SE)	Calculated marginal change, %	Approximate marginal cost change, CAD*	p value†
Intercept	11.979 (0.317)	NA	NA	< 0.001
Wait time between referral and treatment	–0.0170 (0.0103)	–3.8	–902.45	0.10
BMI at admission	–0.0740 (0.0191)	–15.7	–3346.82	< 0.001

Note: R² = 18.3%; BMI = body mass index, CAD = Canadian dollars, NA = not available, SE = standard error.  *Values obtained through regression model of untransformed costs. †Wald test.

View popup

Table 4: Multivariate linear regression model for caregiver costs per admission to hospital for anorexia nervosa in adolescent patients

Predictor variable	Logarithmic cost model (SE)	Calculated marginal change, %	Approximate marginal cost change, CAD*	p value†
Intercept	10.909 (0.585)	NA	NA
Wait time between referral and treatment	–0.0194 (0.0105)	–4.8	–67.01	0.07
Age at admission	–0.0632 (0.0314)	–13.6	–123.08	< 0.05
BMI at admission	–0.113 (0.0222)	–23.0	–364.38	< 0.001

Note: R² = 31.8%; BMI = body mass index, CAD = Canadian dollars, NA = not available, SE = standard error. *Values obtained through regression model of untransformed costs. †Wald test.