Delayed cannabinoid hyperemesis diagnosis cost an average of $77,000 per patient | Research

The takeaway

Seventeen patients eventually diagnosed with cannabinoid hyperemesis averaged 17.9 emergency department visits before diagnosis, with combined ED and imaging costs averaging $76,921 per patient.

Emergency physicians, chronic cannabis users with unexplained vomiting, and healthcare administrators.

17.9 ER visits and $76,921 before diagnosis

What the researchers found

Patients averaged 17.9 ED visits before cannabinoid hyperemesis was diagnosed. Total costs for combined ED visits and radiological evaluations averaged $76,920.92 per patient. The diagnosis can be made primarily through thorough history and physical examination, but requires clinician awareness of the syndrome.

Why it matters

Cannabinoid hyperemesis is becoming more common with increased cannabis use, and the enormous cost of delayed diagnosis represents both wasted healthcare resources and unnecessary patient suffering.

The numbers in context

17 patients. 3 medical centers. 2010-2015. Average 17.9 ED visits before diagnosis. Average cost: $76,920.92 per patient.

How the study worked

Retrospective observational study of 17 patients diagnosed with cannabinoid hyperemesis at three US medical centers (two academic, one community) from 2010 to 2015.

What this study cannot tell us

Very small sample (17 patients). Three centers in one country. Costs may vary by region. Retrospective design. No standardized diagnostic criteria at the time.

How to read the evidence

Very small retrospective case series, but provides compelling cost data highlighting a diagnostic gap.

When this study was published

2019 study using 2010-2015 data.

The bigger picture

As cannabis use increases, clinician awareness of cannabinoid hyperemesis could save significant healthcare costs and spare patients years of unnecessary testing.

Questions still open

How many undiagnosed cannabinoid hyperemesis patients are currently cycling through emergency departments? Would universal cannabis use screening in EDs improve recognition?

Common questions

How long does it take to diagnose cannabinoid hyperemesis?

In this study, patients averaged 17.9 emergency department visits before cannabinoid hyperemesis was diagnosed, at an average cost of nearly $77,000 per patient in ED and imaging charges.

How is cannabinoid hyperemesis diagnosed?

The diagnosis can be made primarily through a thorough patient history and physical exam, but many clinicians lack awareness of the syndrome, leading to extensive and expensive diagnostic workups.

Read the original research

Emergency Department and Radiological Cost of Delayed Diagnosis of Cannabinoid Hyperemesis.

Journal of addiction, 2019, 1307345

View on PubMed ↗Publisher’s paper ↗

Citation

Zimmer, David I; McCauley, Ross; Konanki, Varun; Dynako, Joseph; Zackariya, Nuha; Shariff, Faadil; Miller, Joseph; Binz, Sophia; Walsh, Mark. (2019). Emergency Department and Radiological Cost of Delayed Diagnosis of Cannabinoid Hyperemesis.. Journal of addiction, 2019, 1307345. https://doi.org/10.1155/2019/1307345