Data from: Autoimmune encephalitis: a costly condition

Objective: To assess the inpatient hospitalization burden and costs of
patients with autoimmune encephalitis (AE) at a tertiary care institution.
Methods: Adult inpatients with AE were identified retrospectively from
July 1, 2005 – June 30, 2015. Demographic and clinical data were collected
and analyzed. Billing data were compared to that of patients with herpes
simplex encephalitis (HSE). Charges were adjusted for inflation. Results:
Of 244 admissions for encephalitis reviewed, 63 patients met criteria for
probable or definite AE. Thirty-one (49%) patients were antibody-positive,
and twenty-seven (43%) were admitted to the intensive care unit (ICU).
Median hospital charges per AE patient were over $70k, median length of
stay (LOS) was 15 days, and in hospital mortality was 6%. ICU patients had
substantially higher median hospital charges (ICU $173k/ admission vs.
non-ICU $50k/ admission, p<0.001). LOS was strongly associated with
charges and was driven by delay in diagnosis of AE, prolonged treatment
courses, and lack of response to therapy. In comparison with HSE, median
hospital charges per AE patient were nearly 4 times higher, median AE LOS
was 3 times higher, and total charges over the study period were nearly
twice as high. Conclusions: AE patients utilized more inpatient healthcare
resources per patient during a ten-year period than HSE at our
institution. ICU-admitted AE patients were responsible for a substantially
higher financial burden than non-ICU-admitted AE patients. Our data
underscore the need for the development of novel diagnostic and
therapeutic modalities to improve patient outcomes and decrease hospital
burden in AE.