OBJECTIVES: Meningococcal disease (MD), a highly contagious infection caused by the Neisseria meningitidis bacteria, causes swelling of neurologic (i.e., brain; spinal cord) membranes, and has a case fatality rate of 10-15%. Increasing attention has been given to gaining a fuller understanding of the scope of the economic burden associated with MD. Accordingly, this study assessed trends in MD-hospitalization and aspects of inpatient care in the United States (US).
METHODS: Data for hospitalizations in the US with a primary diagnosis of MD (ICD-9-CM codes 036.0x, 036.1x, or 036.9x) from the 2004 through 2013 Healthcare Cost & Utilization Project’s Nationwide Inpatient Sample databases were analyzed. Weighted estimates of the number and rate of MD-related hospitalizations and associated resource-based outcomes (i.e., total charges, length of stay [LOS]) were derived.
RESULTS: Between 2004 and 2013, rates of MD-related hospitalizations (per 1,000,000 2015 US population) decreased substantially from 3.2/1,000,000 in 2004 to 0.7/1,000,000 in 2013. Mean LOS for these hospitalizations increased by 32%, from 7.2 days in 2004 to 9.5 days in 2013, with a peak of 10.8 days in 2012. Mean per-stay charges (2015 US dollars) for MD-related stays increased across the years assessed, from $46,453 in 2004 to $115,427 in 2015, an increase of 148%. Finally, while per-stay charges have increased over time, the reduction in the number of hospitalizations during the period has resulted in total MD-related inpatient charges falling by nearly 40% percent, from $39.6M in 2004 to $24.8M in 2013.
CONCLUSIONS: We observed a reduction in rates of MD-related hospitalization between 2004 and 2013 of nearly 78%, but an increase in the per-stay economic burden associated with these stays (i.e., >2 day increase in LOS; ~150% increase in per-stay total charges). The documented increases in LOS and per-stay charges emphasize the need for interventions targeted at mitigating disease severity and complications.
