The direct healthcare costs of eating disorders among hospitalized patients: a population-based study

Objective — To estimate the direct healthcare costs of eating disorders in Ontario, Canada, in 2012, using a prevalence-based cost-of-illness approach.

Method — We selected a population-based sample of all patients eligible for public healthcare insurance over the age of 4 with a hospitalization for an eating disorder at any point since 1988. We estimated total and mean direct net costs per patient in 2012, from the third public payer perspective, by sex, age group, and health service type.

Results — In 2012, there were 6,326 patients ever hospitalized for an eating disorder. They had a mean age of 31 at hospitalization, were mostly female (93%), and generally from high-income, urban neighborhoods. Direct total costs were just under $63 million CAD; direct net costs were roughly $48 million CAD. Mean net costs per patient were higher for females than males ($7,743.40 and $6,340.50, respectively), and higher for patients under 20 and patients 65+ ($17,961.50 and $14,953.90, respectively). The main cost drivers were psychiatric hospitalizations and physician visits, although this varied by age group. For younger patients, net costs were mainly because of psychiatric hospitalizations, while for older patients net costs were mainly because of psychiatric and nonpsychiatric hospitalizations, and other care.

Discussion — The cost of eating disorders is substantial and varies by sex and age group. Our findings suggest that, from a healthcare utilization/cost perspective, the effect of eating disorders is likely to persist over the lifespan.