Costs of health care for irritable bowel syndrome, chronic constipation, functional diarrhoea and functional abdominal pain

Abstract

SUMMARY AimTo provide estimates of actual costs to deliver health care to patients with functional bowel disorders, and to assess the cost impact of symptom severity, recency of onset, and satisfaction with treatment. MethodsWe enrolled 558 irritable bowel (IBS), 203 constipation, 243 diarrhoea and 348 abdominal pain patients from primary care and gastroenterology clinics at a health maintenance organization within weeks of a visit. Costs were extracted from administrative claims. Symptom severity, satisfaction with treatment and out-of-pocket expenses were assessed by questionnaires. ResultsAverage age was 52 years, 27% were males, and 59% participated. Eighty percent were seen in primary care clinics. Mean annual direct health care costs were $5049 for IBS, $6140 for diarrhoea, $7522 for constipation and $7646 for abdominal pain. Annual out-of-pocket expenses averaged $406 for treatment of IBS symptoms, $294 for diarrhoea, $390 for constipation and $304 for abdominal pain. Lower gastrointestinal costs comprised 9% of total costs for IBS, 9% for diarrhoea, 6.5% for constipation and 9% for abdominal pain. In-patient care accounted for 17.5% of total costs (15.2% IBS). ConclusionCosts were affected by disease severity (increased), recent exacerbation of bowel symptoms (increased), and whether the patient was consulting for the first time (decreased).

A Systematic Review of the Economic and Humanistic Burden of Illness in Irritable Bowel Syndrome and Chronic Constipation

“…It was appropriate to include these study designs in the systematic review, since the stated criteria excluded studies that reported economic or humanistic outcomes attributable to a particular intervention (which eliminated many interventional studies). Third, the cost estimates used in the economic analyses were often dated: the most recent valuation period for direct costs was for 2000-2003, 21 while for indirect costs the most recent values were for 2001. 32 This hindered the ability to provide a precise estimate of the current economic burden of disease for IBS, IBS subtypes, and CC.…”

Chronic Constipation: An Evidence-Based Review

“…25 Annually, diagnostic workup for constipation averages US$3000 per patient, 26 and it takes another US$4500 per person to provide treatment. 27 In general, constipation has a significant impact on quality-of-life indicators irrespective of culture and nationalities, 28 especially on the elderly. 29 A recent systematic review showed that impairment caused by constipation as measured by Health-Related Quality of Life scores predominates in the mental health domains and is comparable to that caused by serious chronic conditions such as osteoarthritis and diabetes.…”

Use of a Novel Stool Scoring System for Assessing Bowel Habits and Laxatives use Amongst Older People-A Pilot Study in Kingston, Ontario

“…In United States, constipation ranks amongst the top five gastrointestinal reasons for out-patient visits [13]. Diagnostic workup for constipation averages US$3,000 per year [14] and it takes another US$ 4500 per year to provide treatment [15] for patient. Overall, chronic constipation has significant negative impact on patients' quality of life from various culture and nationalities [16], especially in the older people [17] .…”