$2M in hospital costs linked to swallowed foreign objects

knife in esophagusPeople with a consuming passion about swallowing odd foreign objects indulge in a costly habit.

An eight-year retrospective study conducted by doctors at Rhode Island Hospital and published in Clinical Gastroenterology and Hepatology found that more than $2 million in hospital costs could be traced to 33 different people who deliberately ingested 305 foreign objects that had to be removed. Most of the costs were paid by governmental payers; Medicare covered 48 percent of the costs and Medicaid covered 31 percent. While minor complications occurred in 11 endoscopies, there were no deaths or perforations. Only two cases required surgical extractions.

Dr. Steven Moss, a GI at Rhode Island Hospital and lead author of the article and his co-authors conclude that foreign body ingestion is poorly understood, difficult to treat, and consumes considerable physician time and hospital resources. "Attention should be focused on investigating how to avoid these preventable and costly episodes," they write.

The cases studied involved patients who underwent endoscopies to extract the objects between Oct. 1, 2001 and July 31, 2009. Nearly eight in 10 were diagnosed with psychiatric disorders. The most commonly ingested foreign bodies were pens (24 percent), batteries (9 percent), knives (7 percent) and razor blades (7 percent). Coins, spoons and toothbrushes were among other items ingested. (The photo above shows a knife in an esophagus.)

Among estimated costs, $1.5 million consisted of hospital costs, $241,000 in physician fees and $277,000 in security services. Costs were higher for inpatients at $11,273 per admission vs. $2,393 per outpatient incident. The authors note that it would be more cost-efficient to manage such cases on an outpatient basis.

Foreign objects were most often retrieved from the stomach (46 percent) and esophagus (13 percent).

To learn more:
- watch Dr. Steven Moss discuss foreign-body ingestion
- here's the video abstract of Dr. Brian Huang
- read the Clinical Gastroenterology and Hepatology abstract
- check out the Rhode Island Hospital press release

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