Surgical and nonsurgical hospitalization rates and charges for patients with ulcerative colitis in Italy: A 10-year cohort study

Abstract Background Today we are observing an increasing incidence of ulcerative colitis associated with an improved survival of patients. Aim To analyse current rates, outcomes, and costs of inpatient care for ulcerative colitis patients of central Italy. Methods The cohort included 644 ulcerative colitis patients, living in the Lazio region, with diagnosis made or confirmed by the staff of a single tertiary referral centre in Rome (1997–2006). Follow-up data on hospitalization rates, costs, and colectomy rates were collected from the Regional Hospital Information System. Results Overall hospitalization rates were 3 times higher than those of the region's general population, reflecting excess admissions for digestive or infectious diseases (standardized hospitalizations rates for digestive-tract: 15.9; for infectious diseases: 3.5). The overall cumulative risk for colectomy was 7.5%. On the average, hospitalizations for ulcerative colitis lasted 10 days. The mean reimbursement for a ulcerative colitis-related hospitalization was EUR 5120 (€4609 for nonsurgical admissions, €8655 for surgical hospitalizations). Conclusion Ulcerative colitis patients are 3 times more likely to be hospitalized than the general population. Colectomy rates in Italian ulcerative colitis patients resemble those of northern Europe, but most hospital admissions are for diagnostic procedures or medical therapy. Hospitalizations are almost twice as long as those reported in the United States although their mean cost is considerably lower.