Systematic analysis of annual health resource utilization and costs in hospitalized patients with inflammatory bowel disease in Switzerland

Schoepfer, Alain; Vavricka, Stephan R.; Brüngger, Beat; Reich, Oliver; Blozik, Eva; Bähler, Caroline

doi:10.1097/meg.0000000000001160

Cited by 7 publications

(6 citation statements)

References 21 publications

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“…This resulted in nine included publications 7 16–23. Two publications specifically evaluating the use of Swiss claims data in regression models were additionally included 24 25…”

Section: Resultsmentioning

confidence: 99%

Hospital readmission risk prediction based on claims data available at admission: a pilot study in Switzerland

Brüngger

Blozik

2019

BMJ Open

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ObjectivesEvaluating whether future studies to develop prediction models for early readmissions based on health insurance claims data available at the time of a hospitalisation are worthwhile.DesignRetrospective cohort study of hospital admissions with discharge dates between 1 January 2014 and 31 December 2016.SettingAll-cause acute care hospital admissions in the general population of Switzerland, enrolled in the Helsana Group, a large provider of Swiss mandatory health insurance.ParticipantsThe mean age of 138 222 hospitalised adults included in the study was 60.5 years. Patients were included only with their first index hospitalisation. Patients who deceased during the follow-up period were excluded, as well as patients admitted from and/or discharged to nursing homes or rehabilitation clinics.MeasuresThe primary outcome was 30-day readmission rate. Area under the receiver operating characteristic curve (AUC) was used to measure the discrimination of the developed logistic regression prediction model. Candidate variables were theory based and derived from a systematic literature search.ResultsWe observed a 30-day readmission rate of 7.5%. Fifty-five candidate variables were identified. The final model included pharmacy-based cost group (PCG) cancer, PCG cardiac disease, PCG pain, emergency index admission, number of emergency visits, costs specialists, costs hospital outpatient, costs laboratory, costs therapeutic devices, costs physiotherapy, number of outpatient visits, sex, age group and geographical region as predictors. The prediction model achieved an AUC of 0.60 (95% CI 0.60 to 0.61).ConclusionsBased on the results of our study, it is not promising to invest resources in large-scale studies for the development of prediction tools for hospital readmissions based on health insurance claims data available at admission. The data proved appropriate to investigate the occurrence of hospitalisations and subsequent readmissions, but we did not find evidence for the potential of a clinically helpful prediction tool based on patient-sided variables alone.

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“…This resulted in nine included publications 7 16–23. Two publications specifically evaluating the use of Swiss claims data in regression models were additionally included 24 25…”

Section: Resultsmentioning

confidence: 99%

Hospital readmission risk prediction based on claims data available at admission: a pilot study in Switzerland

Brüngger

Blozik

2019

BMJ Open

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“…IBD drugs and specialist consultations each accounted for one third of total costs. As such, these costs are much lower compared with the costs that were generated during an IBD-related hospitalization and an observation period of one year (starting with the day of the index hospitalization) where total median costs were approximately EUR 14 230 for ulcerative colitis patients and EUR 20 000 for Crohn's disease patients [30]. In hospitalized IBD patients, about one-third of total costs was attributed to inpatient costs, whereas IBD drugs were the highest cost position for outpatients [29].…”

Section: Discussionmentioning

confidence: 97%

Systematic analysis of therapeutic patterns and healthcare use during 12 months before inflammatory bowel disease-related hospitalization in Switzerland

Schoepfer

Vavricka²,

Brüngger

et al. 2020

European Journal of Gastroenterology &Amp; Hepatology

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BACKGROUND AND AIMS Given the lack of data, we aimed to systematically analyze therapeutic patterns and health resource utilization in the year before inflammatory bowel disease (IBD)related hospitalization. METHODS Based on claims data of the Helsana health insurance group, therapy patterns and health resource utilization were assessed, and costs reimbursed by mandatory basic health insurance were calculated during a one-year period before an index hospitalization between 1 January 2013 to 31 December 2015. RESULTS We analyzed 344 IBD patients (140 ulcerative colitis [40.7%], 204 Crohn's disease [59.3%]). Drug regimens applied in the year before index hospitalization were as follows: no IBD drugs (43.6% ulcerative colitis, 43.1% Crohn's disease); 5-ASA (45.7% ulcerative colitis, 19.1% Crohn's disease); local steroids (17.9% ulcerative colitis, 17.6% Crohn's disease); systemic steroids (38.6% ulcerative colitis, 29.4% Crohn's disease); immunomodulators (10.7% ulcerative colitis, 18.1% Crohn's disease); biologics (10% ulcerative colitis, 24% Crohn's disease); and calcineurin inhibitors (2.1% ulcerative colitis, 1.5% Crohn's disease). Forty-five percent of ulcerative colitis patients and 31.4% of Crohn's disease patients had no diagnostic procedures [computed tomography (CT), MRI, radiograph, sonography, colonoscopy, and calprotectin] in the year before hospitalization. Total annual health care costs before index hospitalization was EUR 4060 (interquartile range (IQR) 2360-7390) for ulcerative colitis and EUR 4900 (IQR 1520-14 880) for Crohn's disease patients, respectively. CONCLUSIONS Over 40% of ulcerative colitis and Crohn's disease patients did not receive any treatment in the year before index hospitalization. Efforts should be launched to timely diagnose and adequately treat IBD outpatients.

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“…Open access investigated procedures involved in establishing an IBD diagnosis, [14][15][16][17][18][19] which, however, is important to identify shortcomings and areas for potential improvement. The Danish nationwide health registers provide a unique opportunity for such a study.…”

Section: How This Study Might Affect Research Practice or Policymentioning

confidence: 99%

Clinical procedures used to diagnose inflammatory bowel disease: real-world evidence from a Danish nationwide population-based study

Rasmussen

Green

Allin

et al. 2022

BMJ Open Gastroenterol

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ObjectiveAlthough clinical guidelines exist, the diagnostic work-up for diagnosing inflammatory bowel disease (IBD) is complex and varies in clinical practice. This study used real-life data to characterise the current diagnostic procedures used to establish IBD diagnoses in a Danish nationwide setting.DesignPerson-level data on patients diagnosed with IBD between 1 January 2014 and 30 June 2018 were linked between Danish health registers. Information on age, sex, registration of other gastrointestinal diseases, and diagnostic procedures (endoscopies, biopsies, and imaging) performed in relation to the first IBD hospital admission was analysed for the total study population and was stratified by IBD type, sex, and age.ResultsThe majority of the 12 871 patients with IBD included underwent endoscopy (84%), had a biopsy taken (84%), and/or underwent imaging procedures (44%). In total, 7.5% of the population (6% for Crohn’s disease and 8% for ulcerative colitis) were diagnosed with IBD despite not undergoing any of these diagnostic procedures. Patients with Crohn’s disease underwent more procedures than patients with ulcerative colitis (94% vs 92%, p<0.001). Children underwent slightly fewer diagnostic procedures than adults (92% vs 93%, p=0.004). Slightly more men underwent at least one procedure than women (92% vs 94%, p<0.001).ConclusionFor 7.5% of patients with IBD, this study did not detect any registrations of the recommended diagnostic procedures for establishing an IBD diagnosis. Further research is needed to examine whether these findings are mainly explained by limitations of the register data or also indicate shortcomings of the general approach to IBD.

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Systematic analysis of annual health resource utilization and costs in hospitalized patients with inflammatory bowel disease in Switzerland

Abstract: When compared with patients with UC, hospitalized patients with CD have during a 1-year follow-up a higher rate of outpatient consultations and generate higher costs.

Cited by 7 publications

References 21 publications

Hospital readmission risk prediction based on claims data available at admission: a pilot study in Switzerland

Hospital readmission risk prediction based on claims data available at admission: a pilot study in Switzerland

Systematic analysis of therapeutic patterns and healthcare use during 12 months before inflammatory bowel disease-related hospitalization in Switzerland

Clinical procedures used to diagnose inflammatory bowel disease: real-world evidence from a Danish nationwide population-based study

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