Direct health‐care cost utilization in Hong Kong inflammatory bowel disease patients in the initial 2 years following diagnosis

Mak, Lung‐Yi; Ng, Siew C.; Wong, Irene; Li, Michael K K; Lo, Fu Hang; Wong, Margaret Wan Nar; Leung, Chi Man; Tsang, Steven Woon Choy; Chan, Kam Hon; Sze, Shun Fung; Shan, Edwin Hok Shing; Lam, Belsy C Y; Hui, Aric Josun; Hung, Ivan Fan-Ngai; Leung, Wai Keung

doi:10.1111/jgh.13817

Cited by 15 publications

(21 citation statements)

References 29 publications

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“…However, how they affect surgical rates and long-term outcomes is still under investigation. Although several studies have reported short-term trends and hospitalization costs of IBD in China [4,[7][8][9], longitudinal trends of IBD in China still remain unclear.…”

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confidence: 99%

Increasing newly diagnosed inflammatory bowel disease and improving prognosis in China: a 30-year retrospective study from a single centre

Jin

Zhang

et al. 2020

BMC Gastroenterol

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Background We aimed to characterize the trends of prognosis in ulcerative colitis (UC) and Crohn’s disease (CD) in a Chinese tertiary hospital. Methods A 30-year retrospective cohort analysis was conducted at Peking Union Medical College Hospital. Consecutive patients newly diagnosed with UC or CD from 1985 to 2014 were included. The primary outcome was in-hospital mortality. The secondary outcomes included surgery and length of stay in hospital. The Pearson correlation coefficient was applied to determine the relationship between time and prognosis. Multivariable logistic regression analysis was performed to determine the risk factors for in-hospital mortality and surgery. Results In total, 1467 patients were included in this study (898 cases with UC and 569 cases with CD). Annual admissions for UC and CD have increased significantly over the last 30 years (UC, r = 0.918, P < 0.05; CD, r = 0.898, P < 0.05). Decreased in-hospital mortality was observed both in patients with UC and CD (UC, from 2.44 to 0.27%, r = − 0.827, P < 0.05; CD, from 12.50 to 0.00%, r = − 0.978, P < 0.05). A decreasing surgery rate was observed in patients with CD (r = − 0.847, P < 0.05), while an increasing surgery rate was observed in patients with UC (r = 0.956, P < 0.05). Shortened average lengths of hospital stay were observed in both UC and CD patients (UC, from 47.83 ± 34.35 to 23.58 ± 20.05 days, r = − 0.970, P < 0.05; CD, from 65.50 ± 50.57 to 26.41 ± 18.43 days, r = − 0.913, P < 0.05). Toxic megacolon and septic shock were independent risk factors for in-hospital mortality in patients with UC. Intestinal fistula and intestinal perforation were independent risk factors for in-hospital mortality in patients with CD. Conclusions In this cohort, the admissions of patients with UC and CD were increased, with significantly improved prognoses during the past 30 years.

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confidence: 99%

Increasing newly diagnosed inflammatory bowel disease and improving prognosis in China: a 30-year retrospective study from a single centre

Jin

Zhang

et al. 2020

BMC Gastroenterol

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“…However, how they affect surgical rates and long-term outcomes is still under investigation. Although several studies have reported short-term trends and hospitalization costs of IBD in China 3 [6][7][8] , longitudinal trends of IBD in China still remains unclear.…”

Section: Introductionmentioning

confidence: 99%

Increasing Newly Diagnosed Inflammatory Bowel Disease and Improving Prognosis in China: A 30-year Retrospective Study From a Single Center

Jin

Zhang

et al. 2020

Preprint

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Background: We aimed to characterize the trends of prognosis in Ulcerative Colitis (UC) and Crohn’s Disease (CD) in a Chinese tertiary hospital. Methods: A 30-year retrospective cohort analysis was conducted at Peking Union Medical College Hospital. Consecutive patients newly diagnosed with UC or CD from 1985 to 2014 were included. The primary outcome was in-hospital mortality. Second outcomes included surgery and length of stay in hospital. Pearson correlation coefficient was performed to determine the relationship between time and prognosis. Multivariable logistic regression analysis was performed to determine the risk factors for in-hospital mortality and surgery. Results: In total, 1467 patients were included in this study (898 cases with UC and 569 cases with CD). Annual admissions of UC and CD rose significantly over the last 30 years (UC, r=0.918, P<0.05; CD, r=0.898, P<0.05). Decreased in-hospital mortalities were observed in patients with UC and CD (UC, from 2.44% to 0.27%, r=-0.827, P<0.05; CD, from 12.50% to 0.00%, r=-0.978, P<0.05). A decreasing surgery rate was observed in patients with CD (r=-0.847, P<0.05) while an increasing surgery rate was observed in patients with UC (r=0.956, P<0.05). Shortened average lengths of stay in hospital were observed both in patients with UC and CD (UC, from 47.83±34.35 days to 23.58±20.05 days, r=-0.970, P<0.05; CD, from 65.50±50.57days to 26.41±18.43 days, r=-0.913, P<0.05). Toxic megacolon, sepsis shock were independent risk factors for in-hospital mortality in patients with UC. Intestinal fistula, intestinal perforation were independent risk factors for in-hospital mortality in patients with CD. Conclusions: In this cohort, the admissions of patients with UC and CD were increased with a significantly improved prognosis during past 30 years.

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“…One study from China in 2017 reported that 30.6% of the patients with IBD spent over half of their income to cover medical costs [15]. A retrospective cohort study in Hongkong reported that the total direct medical expenditure was US $7,072,710 for 435 patients with IBD, wherein hospitalizations (33%) and 5-aminosalicylic acid (23%) therapy accounted for the most part [16]. However, economic data and association between financial burden and health care access in mainland China are still lacking.…”

Section: Introductionmentioning

confidence: 99%

Economic Burden and Health Care Access for Patients With Inflammatory Bowel Diseases in China: Web-Based Survey Study (Preprint)

Yu¹,

Zhu²,

Shi³

et al. 2020

Preprint

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BACKGROUND The increasing incidence of inflammatory bowel disease (IBD) has brought heavy cost burdens for Chinese patients; however, data about their financial status and access to health care are still lacking. This information is important for informing IBD patients about disease budgets and health care strategies. OBJECTIVE This study evaluated the economic status and medical care access of IBD patients through the CCCF (China Crohn’s and Colitis Foundation) internet platform in China. METHODS Our study was performed in 14 IBD centers in mainland China between 2018 and 2019 through WeChat platform. Totally 3000 IBD patients consisting of 1922 patients with Crohn’s disease (CD), 973 patients with ulcerative colitis (UC), and 105 patients with undetermined colitis completed the 64-item questionnaires for analysis. Data were collected by the Wenjuanxing survey program on internet. RESULTS The median age of the respondents was 34 years (range 18–73 years). The income of 85.5% of the patients was under ¥10,000 per month. Health medical insurance covered 96.5% of the patients, but only 14.4% of the patients had commercial insurance, which has higher imbursement ratios. During the last 12 months, the outpatient costs for 41.7% of the patients were over ¥20,000, and the inpatient expenses for 30.7% of the patients exceeded ¥50,000. The average reimbursement ratios for most outpatient and inpatient costs were less than 60%. In addition, 61.7% (n=626) of the patients covered biological agents at their own expense without any reimbursement. Approximately half of the respondents (42.7%) had no primary care provider (PCP) (n = 1282), and 52.2% of the patients needed to go to the ER 1-4 times per year because of IBD, lower level of income, higher travel and accommodation costs were significantly associated with ER times More than 50% of the patients were >50 km away from the closest IBD center, and more than 70% of the patients needed >1 hr to get to the closest IBD center. In all, 98.0% (n = 2954) of the patients worried about their financial problems; thus, 79.7% (n = 2392) of the IBD patients sought ways to save money for health care and even delayed their health care or medical treatments. CONCLUSIONS Chinese patients with IBD have enormous financial burdens and difficulties related to health care access, which have increased their economic worries and inevitably influenced their disease management. Advanced measures should be taken to reduce health care spending and improve disease outcomes. CLINICALTRIAL none

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Direct health‐care cost utilization in Hong Kong inflammatory bowel disease patients in the initial 2 years following diagnosis

Cited by 15 publications

References 29 publications

Increasing newly diagnosed inflammatory bowel disease and improving prognosis in China: a 30-year retrospective study from a single centre

Increasing newly diagnosed inflammatory bowel disease and improving prognosis in China: a 30-year retrospective study from a single centre

Increasing Newly Diagnosed Inflammatory Bowel Disease and Improving Prognosis in China: A 30-year Retrospective Study From a Single Center

Economic Burden and Health Care Access for Patients With Inflammatory Bowel Diseases in China: Web-Based Survey Study (Preprint)

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