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Canadian Journal of Gastroenterology
Volume 16, Issue 10, Pages 677-682
Original Article

Resource Utilization for Acute Lower Gastrointestinal Hemorrhage: The Ontario GI Bleed Study

Dan Comay and John K Marshall

Department of Medicine (Division of Gastroenterology), McMaster University, Hamilton, Ontario, Canada

Received 14 January 2002; Accepted 1 August 2002

Copyright © 2002 Hindawi Publishing Corporation. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.


OBJECTIVES: Acute lower gastrointestinal hemorrhage (LGIH) is a common indication for hospitalization. However, there are few published studies of related health care resource utilization. Resource utilization, length of stay (LOS) and direct medical costs were characterized in a cohort of patients admitted for nonmalignant LGIH to centres in Ontario.

METHODS: Consecutive admissions for LGIH were identified at four Ontario hospitals. Profiles of resource utilization, LOS and estimates of direct medical costs were compiled through detailed chart review and adaptation of an administrative database. All centres were participants in the Ontario Case Cost Project. Linear regression models of log-transformed data were constructed to identify demographic variables predictive of LOS and case cost.

RESULTS: Among 124 patients enrolled (mean age 58.8 years) the average case cost was $4,832 (SD $7,187) for 7.5 days in hospital (SD 12.0). Diverticular disease was the bleeding source most often identified (34.6%), followed by hemorrhoids (13.7%) and ischemic colitis (9.7%). Older age and comorbid illness, specifically coronary artery disease (CAD), were associated with both increased LOS and higher case cost in univariate regression analyses. Age persisted as the lone independent predictor of LOS in the multivariate model (P<0.05, R2=0.076), and age and CAD were both independent predictors of cost (P<0.05, R2=0.109) in a stepwise multiple linear regression analysis. Neither sex nor nonsteroidal anti-inflammatory drug use predicted LOS or cost.

CONCLUSIONS: Admissions for acute LGIH are associated with significant resource utilization, particularly among elderly patients with CAD.