(1) Introduction: Acute pancreatitis (AP) remains a global burden of cost for healthcare services. We found a high degree of heterogeneity in cost-related reports and a scarcity of data regarding the cost of AP episodes in European and Asian populations. We aimed to estimate the median daily cost of hospitalisation (DCH) of AP in our population. Our secondary aims included estimating the total cost of hospitalisation (TCH) and the total cost of AP in Romania, as well as assessing the correlation between median DCH and ward, age, sex, length of stay (LoS), intensive care unit (ICU), outcome, severity, morphology, and aetiology of AP. (2) Material and methods: This retrospective cohort study included 1473 cases recruited from the electronic health records of the University Emergency Hospital of Bucharest. Statistical tests used included Kolmogorov-Smirnov, Kruskal-Wallis with post-hoc Dunn-Bonferroni, and Pearson correlation two-tailed. (3) Results: We found a median DCH of AP of USD 203.8 and a median TCH of USD 1360.5. The total yearly cost of AP in Romania was estimated at around USD 19 million. The majority of males with AP (61.8%) were mostly discharged as healed/ameliorated (83.8%); a majority had local complications (55.4%), which were mostly alcohol-related (35.1%). Regarding the aetiology, biliary-related AP was a cost driver, with significant statistical differences observed in all studied groups (p < 0.01). Morphology assessment revealed that acute necrotic collections were associated with high cost and meaningful disparities among the groups (p < 0.01). Cost was also associated with severity, with significant deviations among all groups (p < 0.01). Outcome-at-discharge as deceased correlated with higher costs, with substantial differences within groups (p < 0.01). The need for an intensive care unit was also a large driver of cost (p < 0.01). Females were prone to more expensive costs (p < 0.01). Surgical cases necessitated more financial resources (p < 0.01). (4) Conclusions: To the best of our knowledge, this is the first study on the cost of AP in Romania. Our findings showed that the drivers of increased AP costs might be older age, ICU, intra-hospital mortality, severe AP, local complications such as acute necrotic collections, biliary aetiology, and female sex. We found large heterogeneity and scarcity regarding cost-related data in the literature.
Keywords: acute pancreatitis; costs; daily cost; financial burden; severity.