June 26, 2014

Changes in hospitalization rates and length of stay in people with MS

According to findings from a retrospective observational study conducted in British Columbia, hospital admissions for MS have decreased over the past 20 years, but the length of stay has increased. [Charity Evans, PhD; Elaine Kingwell, PhD; Feng Zhu, MSc; Joel Oger, MD, FRCPC, FAAN; Yinshan Zhao, PhD; and Helen Tremlett, PhD. (Am J Manag Care. 2012;18(11):735-742)]

The Study:  The purpose of this study was to examine patterns, temporal trends (changes over time), and patient characteristics influencing hospital admissions in a large MS cohort in British Columbia over a 20-year period. This study included data from 6601 people within the British Columbia MS database linked with the BC Ministry of Health’s hospital registry administrative data from 1986 until 2008. Seventy-eight per cent of the people included in the study had at least one hospital admission between 1986 and 2008, with an overall admission rate of 32 per 100 patients. Higher admission rates and longer stays were associated with older age, the presence of a primary progressive disease course, and a longer disease duration. The length of hospital stays increased over the study period, averaging 10 days for all inpatient admissions, and 13 days if the admission was MS-related.

The study highlights numerous changes in the management of MS over the past twenty years which may have influenced hospital admission patterns, including earlier diagnosis and treatment of MS,  the  treatment of  MS relapses on an outpatient basis using  intravenous steroid injections administered at home and the introduction of disease modifying therapies that reduce relapses and relapse-related disability.

This is one of the first Canadian population-based studies to examine hospital admissions in people with MS over an extended period of time. The impact of time and patient characteristics on hospitalizations in MS is important for hospital resource planning and designing future research studies investigating MS treatments and interventions.