Forecasting Multiple Sclerosis Hospitalization and Healthcare Burden in the United States from 2017 to 2040 (P4.6-007)

Objective: To forecast multiple sclerosis (MS) hospitalization and burden in the United States from 2017–2040. Background: In the backdrop of recent cost-containment reforms, the increment in the annual MS hospitalization rates over the last decade often question the future economic viability for neuro-care delivery to MS patients. As the focus on improving value in healthcare delivery is gaining national momentum, forecasting healthcare burden is beneficial for prioritizing resources. Design/Methods: A time-series analysis using Autoregressive Integrated Moving Average(ARIMA) models were performed to forecast MS burden in the US between 2017–2040 based upon epidemiological data from the National Inpatient Sample 2001–2016 on MS admissions [ICD-9/10: 340, G35]. Primary outcomes were projections for annual MS hospitalization rates, case-fatality, discharge disposition, costs, length of stay(LOS) until 2040, measured as a percent-change compared to the baseline 2016 year. Results: In 2030 and 2040, MS admissions is predicted to increase by approximately 32%(n=198,361) and 55%(n=232,597) respectively, from baseline 2016(n=150,430). The inpatient mortality will not likely witness a major deviation from their current trends [0.32% in 2016] versus 0.22% in 2030 and 0.19% in 2040. However, a higher proportion of inpatients are likely to witness non-routine discharges(rehabilitation) in 2030 [+43%; n=13737] and 2040[+67%; n=16059] versus 2016(n=9619). The average LOS will decrease by 7% in 2030[5.05 days] and by 13% in 2040[4.68 days] from baseline 5.41 days(2016). Despite decrease in LOS, the cost of care will increase by 17%(+$2,073) in 2030 and 28%(+$3,504) in 2040 versus US$12333(2016), when inflation-adjusted to the 2018-dollar amounts. Conclusions: From a policymaking perspective, these projections serve as an adjunct for assessing appropriate future in-training neurologists needed to be trained in MS sub-specialty to meet demands and reduce access disparities. Prioritizing resources for the establishment of formal, ACGME-accredited MS fellowship programs are warranted to optimize MS care. To curtail increasing costs, strategies promoting administrative efficiencies can aid in providing affordable care. Disclosure: Dr. Sharma has nothing to disclose. Dr. Bittner has nothing to disclose. Dr. Cho has received personal compensation for consulting, serving on a scientific advisory board, speaking, or other activities with Optum.