Impact of Anemia on Medical Resource Utilization and Hospitalization Cost in Women with Obstetrical Bleeding.

Abstract

Abstract Objective: Anemia during pregnancy has been associated with adverse maternal and fetal outcomes. Although women with obstetrical bleeding are at increased risk for developing anemia, little is known about the prevalence and burden associated with anemia in hospitalized women with this condition. This study was conducted to estimate the prevalence, demographic characteristics, medical resource utilization, and hospitalization cost associated with anemia in hospitalized women with obstetrical bleeding in the U.S. Methods: The Healthcare Cost and Utilization Project Nationwide Inpatient Sample (2003) was queried using ICD-9-CM codes to identify all pregnancy-related discharges as well as discharges with diagnosis codes for conditions associated with obstetrical bleeding. Descriptive statistics were used to evaluate demographic characteristics, medical resource utilization components, and hospitalization cost for two groups: cases with anemia and cases without anemia. Results: Of the estimated 4,525,714 pregnancy-related discharges in the U.S. in 2003, more than 250,000 recorded diagnosis codes associated with obstetrical bleeding. Nearly 1 in 5 of these women had an anemia diagnosis. A diagnosis of anemia in hospitalized women with obstetrical bleeding was associated with a 9-fold increase in blood transfusion (p<.0001), 33% longer average length of stay (p<.0001), and 50% higher mean cost per hospitalization (p<.0001). Conclusions: Anemia and blood transfusion are frequently observed in hospitalized women with obstetrical bleeding. To improve outcomes in these patients and alleviate the adverse impact of anemia on postpartum health status, greater provider awareness of the prevalence and burden of illness associated with anemia in hospitalized women with obstetrical bleeding is warranted.