Direct health-care cost utilization in Hong Kong inflammatory bowel disease patients in the initial 2 years following diagnosis
| Autor: | K H Chan, Ivan Hung, Marc T L Wong, Edwin Hok Shing Shan, Aric J. Hui, Fu Hang Lo, Siew C. Ng, Belsy C Y Lam, CM Leung, Wai K. Leung, Shun Fung Sze, Irene O.L. Wong, S W C Tsang, Michael K. K. Li, Lung-Yi Mak |
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| Rok vydání: | 2017 |
| Předmět: |
Crohn's disease
medicine.medical_specialty Health economics Hepatology business.industry Incidence (epidemiology) Gastroenterology Retrospective cohort study Disease medicine.disease Ulcerative colitis Inflammatory bowel disease digestive system diseases Surgery 03 medical and health sciences 0302 clinical medicine 030220 oncology & carcinogenesis Internal medicine Cohort Medicine 030211 gastroenterology & hepatology business |
| Zdroj: | Journal of Gastroenterology and Hepatology. 33:141-149 |
| ISSN: | 0815-9319 |
| Popis: | Background and Aim There is scanty data on the healthcare utilization from Asia where the incidence of inflammatory bowel disease (IBD) is rising rapidly. We aim to determine the direct healthcare costs in the first two-year of diagnosis in an IBD cohort from Hong Kong, and the factors associated with high cost-outliers. Methods This is a retrospective cohort study which included patients newly diagnosed with IBD in a territory-wide IBD registry. Patients’ clinical information, hospitalization records, investigations and IBD treatments were retrieved for up to two years following diagnosis of IBD. Results Four hundred and thirty-five newly diagnosed IBD patients were included: 198 with Crohn's disease (CD), 237 with ulcerative colitis (UC). Total direct medical expenditure for this cohort in the two years after the IBD diagnosis was US$7,072,710: hospitalizations (33%), 5-aminosalicylic acid (5-ASA) (23%), imaging and endoscopy (17%), outpatient visits (10%), surgery (8%), and biologics (6%). Mean direct medical costs per patient-year were significantly higher for CD ($9,918) than UC ($6,634; P = 0.001). The total direct healthcare cost decreased significantly after transition to the second year (P 90th percentile) outliers were associated with surgery (OR 7.1, 95% CI 2.9-17.2) and low haemoglobin on presentation (OR 0.83, 95% CI 0.70-0.96). Conclusions Hospitalization and 5-ASA usage accounted for 56% of total direct medical costs in the first two-year of our newly diagnosed IBD patients. Direct health care costs were higher in the first-year compared to the second-year of diagnosis. Surgery and low haemoglobin on presentation were associated with high cost-outliers. |
| Databáze: | OpenAIRE |
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