Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2017 Apr;5(4):E261-E271.
doi: 10.1055/s-0043-102402.

Utilization trends in inpatient endoscopic retrograde cholangiopancreatography (ERCP): A cross-sectional US experience

Moiz Ahmed  1 , Ritesh Kanotra  2 , Ghanshyambhai T Savani  3 , Fenilkumar Kotadiya  4 , Nileshkumar Patel  5 , Sarah Tareen  6 , Matthew J Fasullo  7 , Mayurathan Kesavan  8 , Ahsan Kahn  8 , Nikhil Nalluri  1 , Hafiz M Khan  1 , Dhaval Pau  1 , Jeffrey Abergel  8 , Liliane Deeb  8 , Sherif Andrawes  8 , Ananya Das  9
Affiliations

Utilization trends in inpatient endoscopic retrograde cholangiopancreatography (ERCP): A cross-sectional US experience

Moiz Ahmed et al. Endosc Int Open. 2017 Apr.

Abstract

Study aims The goal of our study was to determine the current trends for inpatient utilization for endoscopic retrograde cholangiopancreatography (ERCP) and its economic impact in the United States between 2002 and 2013. Patients and methods A Nationwide Inpatient Sample from 2002 through 2013 was examined. We identified ERCPs using International Classification of Diseases (ICD-9) codes; Procedure codes 51.10, 51.11, 52.13, 51.14, 51.15, 52.14 and 52.92 for diagnostic and 51.84, 51.86, 52.97 were studied. Rate of inpatient ERCP was calculated. The trends for therapeutic ERCPs were compared to the diagnostic ones. We analyzed patient and hospital characteristics, length of hospital stay, and cost of care after adjusting for weighted samples. We used the Cochran-Armitage test for categorical variables and linear regression for continuous variables. Results A total of 411,409 ERCPs were performed from 2002 to 2013. The mean age was 59 ± 19 years; 61 % were female and 57 % were white. The total numbers of ERCPS increased by 12 % from 2002 to 2011, which was followed by a 10 % decrease in the number of ERCPs between 2011 and 2013. There was a significant increase in therapeutic ERCPs by 37 %, and a decrease in diagnostic ERCPs by 57 % from 2002 to 2013. Mean length of stay was 7 days (SE = 0.01) and the mean cost of hospitalization was $20,022 (SE = 41). Conclusions Our large cross-sectional study shows a significant shift in ERCPs towards therapeutic indications and a decline in its conventional diagnostic utility. Overall there has been a reduction in inpatient ERCPs.

PubMed Disclaimer

Conflict of interest statement

Competing interests None

Figures

Fig. 1
Fig. 1
Trends for in-hospital diagnostic and therapeutic ERCPs throughout the United States ERCP, endoscopic retrograde cholangiopancreatography
Fig. 2
Fig. 2
Multivariate predictors of length of hospital stay post-ERCP ERCP, endoscopic retrograde cholangiopancreatography
Fig. 3
Fig. 3
Multivariate predictors of highest quartile of cost of care for in-hospital ERCP ERCP, endoscopic retrograde cholangiopancreatography
See this image and copyright information in PMC

References

    1. [Anonymous]NIH state-of-the-science statement on endoscopic retrograde cholangiopancreatography (ERCP) for diagnosis and therapy NIH Consens State Sci Statements 2002191–26. - PubMed
    1. Adler D G, Baron T H, Davila R E et al.ASGE guideline: the role of ERCP in diseases of the biliary tract and the pancreas. Gastrointest Endosc. 2005;62:1–8. - PubMed
    1. Sood N, Huckfeldt P J, Escarce J J et al.Medicare's bundled payment pilot for acute and postacute care: analysis and recommendations on where to begin. Health Aff (Millwood) 2011;30:1708–1717. - PMC - PubMed
    1. Healthcare Cost and Utilization P . Rockville (MD): Agency for Healthcare Research and Quality (US); 2009. HCUP Facts and Figures. In, HCUP Facts and Figures: Statistics on Hospital-Based Care in the United States, 2007. - PubMed
    1. Mazen Jamal M, Yoon E J, Saadi A et al.Trends in the utilization of endoscopic retrograde cholangiopancreatography (ERCP) in the United States. Am J Gastroenterol. 2007;102:966–975. - PubMed