The direct medical cost of epididymitis and orchitis: evidence from a study of insurance claims.

BACKGROUND: Epididymitis and orchitis (EO) are the primary sequelae of acute chlamydia and gonorrhea in men. Existing estimates of the cost per episode of epididymitis are over 10 years old or are based on limited data.

OBJECTIVE: The objective of this study was to estimate direct medical costs of EO from insurance claims data.

STUDY DESIGN: We used 1998 and 1999 insurance claims taken from a national database. We used International Classification of Diseases, 9th Revision codes to identify inpatient and outpatient claims for EO treatment. Prescription drug claims were identified with National Drug Codes. To capture episodes of EO that were most likely sequelae of sexually transmitted diseases, we categorized claims based on age at the time of the initial EO claim.

RESULTS: The total cost per episode was US dollars 368 for males <13 years of age, US dollars 242 for those > or =13 and <41 years of age, and US dollars 291 for those > or =41 years of age. The cost for both younger and older men was significantly different from men > or =13 and <41 years of age. Inpatient claims were relatively rare, occurring in < or =1.2% of total episodes.

CONCLUSION: The cost per episode we calculated was lower than previously published estimates and can be attributed to a lower rate of inpatient care than previously observed or estimated.