Cost Analysis and Cost Determinants in a European Inflammatory Bowel Disease Inception Cohort With 10 Years of Follow-up Evaluation

Odes, Selwyn; Vardi, Hillel; Friger, Michael; Wolters, Frank; Rüssel, Maurice G.; Riis, Lene; Munkholm, Pia; Politi, Pierluigi; Tsianos, Epameinondas V.; Clofent, Juan; Vermeire, Séverine; Monteiro, Estela; Mouzas, I.A.; Fornaciari, Giovanni; Sijbrandij, Jildou; Limonard, Charles; Zeijl, Gilbert Van; O’Moráin, Colm; Moum, Bjørn; Vatn, Morten H.; Stockbrügger, Reinhold W.

doi:10.1053/j.gastro.2006.05.052

Cited by 206 publications

(186 citation statements)

References 19 publications

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“…Lower tenyear cumulative hospitalization rates were also reported in the ECIBD study [20] . The cumulative risk of hospitalization was 52.7% within ten years of diagnosis, with considerable geographical differences.…”

Section: Discussionsupporting

confidence: 69%

Prevalence and predictors of hospitalization in Crohn’s disease in a prospective population-based inception cohort from 2000-2012

Golovics¹,

Lakatos²,

Mandel³

et al. 2015

WJG

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AIM:To analyze the prevalence, length and predictors of hospitalization in the biological era in the populationbased inception cohort from Veszprem province. METHODS:Data of 331 incident Crohn's disease (CD) patients diagnosed between January 1, 2000 and December 31, 2010 were analyzed (median age at diagnosis: 28; IQR: 21-40 years). Both in-and outpatient records were collected and comprehensively reviewed. RESULTS:Probabilities of first CD-related hospitalization and re-hospitalization were 32.3%, 45.5%, 53.7% and 13.6%, 23.9%, 29.8%, respectively after one, three and five years of follow-up in Kaplan-Meier analysis. First-year hospitalizations were related to diagnostic procedures (37%), surgery or disease activity (27% and 21%). Non-inflammatory disease behavior at diagnosis (HR = 1.32, P = 0.001) and perianal disease (HR = 1.47, P = 0.04) were associated with time to first CD-related hospitalization, while disease behavior change (HR = 2.38, P = 0.002) and need for steroids (HR = 3.14, P = 0.003) were associated with time to first re-hospitalization in multivariate analyses. Early CD-related hospitalization (within the year of diagnosis) was independently associated with need for immunosuppressives (OR = 2.08, P = 0.001) and need for surgeries (OR = 7.25, P < 0.001) during the disease course. Observational Study Prevalence and predictors of hospitalization in CONCLUSION:Hospitalization and re-hospitalization rates are still high in this cohort, especially during the first-year after the diagnosis. Non-inflammatory disease behavior at diagnosis was identified as the pivotal predictive factor of both hospitalization and rehospitalization. Core tip: Recent data on hospitalization rates in Crohn' s disease (CD) are lacking from population-based studies. In the present study our aim was to analyze the prevalence, cause and predictors of hospitalization and re-hospitalization in the population-based inception cohort from Veszprem province. Relatively high rates of CD-related hospitalizations and re-hospitalizations were found in our cohort, especially during the first year after the diagnosis. Non-inflammatory disease behavior at diagnosis, behavior change in patients with initial B1 behavior, perianal disease and total AZA and anti-TNF exposure was associated with the time to first CD-related hospitalization. Early CD-related hospitalization was associated with non-inflammatory disease behavior, perianal or internal fistulizing disease, need for immunosuppressives and need for surgeries during the disease course. Key words:Golovics PA, Lakatos L, Mandel MD, Lovasz BD, Vegh Z, Kurti Z, Szita I, Kiss LS, Pandur T, Lakatos PL. Prevalence and predictors of hospitalization in Crohn's disease in a prospective population-based inception cohort from

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Section: Discussionsupporting

confidence: 69%

Prevalence and predictors of hospitalization in Crohn’s disease in a prospective population-based inception cohort from 2000-2012

Golovics¹,

Lakatos²,

Mandel³

et al. 2015

WJG

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“…Despite the high RR rating, the study may be subject to sample bias because all patients were selected from a single hospital. Cost estimates from the two studies that used survey data to estimate utilization (Stark et al 25 and Odes et al 26 ) varied substantially. Of all European studies, the cost components in the study by Stark et al…”

Section: Direct Medical Costsmentioning

confidence: 99%

Systematic review: the costs of ulcerative colitis in Western countries

Cohen

et al. 2010

Aliment Pharmacol Ther

245

151

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“…24 Another study found that, over a 10-year period, the cost of hospitalization was 45% of the total cost of UC treatment. 25 Also, data from the Healthcare Cost and Utilization Project (HCUP) showed that the mean length of stay and the mean cost of hospitalization for inflammatory bowel diseases, including UC, were higher than for all conditions combined, using pooled data (6.1 days vs. 4.6 days and $9,200 vs. $7,700, respectively). 26 The present study sought to identify the total all-cause health care costs incurred by patients with UC, using a large database containing information from managed care plans in different regions of the United States, and to identify component cost categories for 3 age-stratified subgroups.…”

mentioning

confidence: 99%

Administrative Claims Analysis of All-Cause Annual Costs of Care and Resource Utilization by Age Category for Ulcerative Colitis Patients

Bickston

Waters²,

Dabbous³

et al. 2008

JMCP

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BACKGROUND: Ulcerative colitis (UC) is a chronic inflammatory disease with peak incidence in the third decade of life and a second peak in the sixth or seventh decade. While drug therapy can be used to control the inflammation and reduce symptoms, patients with UC may be treated surgically. There is little information in the published literature evaluating the all-cause health care costs of patients with UC according to age.OBJECTIVE: To assess from administrative claims the direct all-cause (not disease-related) costs of care and resource utilization for patients with UC compared with members without UC by 3 age categories.METHODS: A retrospective analysis was conducted using the PharMetrics database of patients with a diagnosis of UC (International Classification of Diseases, Ninth Revision, Clinical Modification [ICD-9-CM] code 556.x) from January 1, 2000 , through June 30, 2005. This database contains enrollment data and pharmacy and medical claims from more than 85 different managed care organizations and more than 55 million patients in the United States. Patients had to be continuously enrolled for 6 months before and 12 months after the initial UC diagnosis and have at least 2 distinct claims with a diagnosis code for UC. The mean per-patient health care resource utilization and costs were calculated for patients in the year following their initial UC diagnosis and compared with the same measures for a group of age-and gender-matched members (without UC claims) at a ratio of 4:1. Three age groups were analyzed: pediatric-adolescent (aged < 18 years), adults (aged 18 to 64 years), and older adults (aged ≥ 65 years). Differences in the measures of all-cause health care resource utilization (claims and costs) between the UC and non-UC groups were tested for statistical significance using the Wilcoxon signed-rank test, a non-parametric alternative to the paired t test. Differences between the 3 age cohorts were tested using the Mann-Whitney U test. RESULTS: Data were collected for 15,105 patients with UC and for 59,159 members in the comparator cohort without UC matched by age and gender. The average age for both cohorts was 44 years, and 54% were female. Mean ([SD], median) annual all-cause total health care costs in 2005 dollars for patients with UC were $13,233 ([$40,715], $5,190) versus $3,214 ([$12,741], $753) for the comparator group (P < 0.001). For all UC patients, all-cause inpatient hospitalization costs constituted the largest component ($5,771, 43.6%) of the mean annual total costs, followed by prescription medications ($2,423, 18.3%); miscellaneous services, such as hospice, psychiatric facility, and nursing home care ($2,092, 15.8%); outpatient hospital visits ($1,310, 9.9%); physician office visits ($899, 6.8%); laboratory procedures ($470, 3.6%); and emergency department visits ($268, 2.0%). Resource utilization (e.g., physician visits, laboratory claims, pharmacy claims) was highest for older adults aged ≥ 65 years, followed by pediatricadolescent patients and adults aged 18 to 64 y...

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Cost Analysis and Cost Determinants in a European Inflammatory Bowel Disease Inception Cohort With 10 Years of Follow-up Evaluation

Cited by 206 publications

References 19 publications

Prevalence and predictors of hospitalization in Crohn’s disease in a prospective population-based inception cohort from 2000-2012

Prevalence and predictors of hospitalization in Crohn’s disease in a prospective population-based inception cohort from 2000-2012

Systematic review: the costs of ulcerative colitis in Western countries

Administrative Claims Analysis of All-Cause Annual Costs of Care and Resource Utilization by Age Category for Ulcerative Colitis Patients

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