A Phenome-Wide Analysis of Healthcare Costs Associated with Inflammatory Bowel Diseases.
Dig Dis Sci
; 66(3): 760-767, 2021 03.
Article
en En
| MEDLINE
| ID: mdl-32436120
ABSTRACT
INTRODUCTION:
Crohn's disease (CD) and ulcerative colitis (UC) are associated with considerable direct healthcare costs. There have been few comprehensive analyses of all IBD- and non-IBD comorbidities that determine direct costs in this population.METHODS:
We used data from a validated cohort of patients with inflammatory bowel disease (IBD). Total healthcare costs were estimated as a sum of costs associated with IBD-related hospitalizations and surgery, imaging (CT or MR scans), outpatient visits, endoscopic evaluation, and emergency room (ER) care. All ICD-9 codes were extracted for each patient and clustered into 1804 distinct phecode clusters representing individual phenotypes. A phenome-wide association analysis (PheWAS) was performed using logistic regression to identify predictors of being in the top decile of costs.RESULTS:
Our cohort is comprised of 10,721 patients with IBD among whom 50% had CD. The median age was 46 years. The median total cost per patient is $11,203 (IQR $2396-30,563). The strongest association with total healthcare costs was intestinal obstruction without mention of hernia (p = 5.93 × 10-156) and other intestinal obstruction (p = 9.24 × 10-131). In addition, strong associations were observed for symptoms consistent with severity of IBD including the presence of fluid-electrolyte imbalance (p = 1.90 × 10-130), hypovolemia (p = 1.65 × 10-114), abdominal pain (p = 7.29 × 10-60), and anemia (p = 1.90-10-83). Cardiopulmonary diseases and psychological comorbidity also demonstrated significant associations with total costs with the latter being more strongly associated with ER visit-related costs.CONCLUSIONS:
Surrogate markers suggesting possible irreversible bowel damage and active disease demonstrate the greatest influence on IBD-related healthcare costs.Palabras clave
Texto completo:
1
Colección:
01-internacional
Banco de datos:
MEDLINE
Asunto principal:
Enfermedades Inflamatorias del Intestino
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Colitis Ulcerosa
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Enfermedad de Crohn
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Costos de la Atención en Salud
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Hospitalización
Límite:
Adult
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Female
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Humans
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Male
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Middle aged
Idioma:
En
Revista:
Dig Dis Sci
Año:
2021
Tipo del documento:
Article
País de afiliación:
Estados Unidos