Health Care Use by a Population-Based Cohort of Children With Inflammatory Bowel Disease

Singh, Harminder; Nugent, Zoann; Targownik, Laura E.; El‐Matary, Wael; Brownell, Marni; Bernstein, Çharles N.

doi:10.1016/j.cgh.2015.01.022

Cited by 18 publications

(19 citation statements)

References 20 publications

(15 reference statements)

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“…Even in the 12-to-9 month period before diagnosis, youth with SLE had more visits than controls. Our findings are consistent with studies of other autoimmune conditions such as pediatric-onset inflammatory bowel disease, where physician visits for abdominal pain increase several years prior to diagnosis (32). In addition, the increased prediagnosis visits in our study extended from physician visits to emergency care and hospitalizations, and involved providers of various specialties.…”

Section: Discussionsupporting

confidence: 91%

“…Our findings are consistent with studies of other autoimmune conditions such as pediatric-onset inflammatory bowel disease, where physician visits for abdominal pain increase several years prior to diagnosis. 32 In addition, the increased pre-diagnosis visits in our study extended from physician visits to emergency care and hospitalizations, and involved providers of various specialties. This pattern of multiple health system interactions across ambulatory and acute care settings was similar for both adolescents and transition-age young adults.…”

Section: Discussionmentioning

confidence: 95%

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High Health Care Utilization Preceding Diagnosis of Systemic Lupus Erythematosus in Youth

Chang

Mandell

Knight

2018

Arthritis Care & Research

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Section: Discussionsupporting

confidence: 91%

Section: Discussionmentioning

confidence: 95%

High Health Care Utilization Preceding Diagnosis of Systemic Lupus Erythematosus in Youth

Chang

Mandell

Knight

2018

Arthritis Care & Research

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“…In Canada, patients with IBD see a physician for their IBD between two and four times per year (22, 28), with the greatest number of visits occurring in the year following diagnosis. Children with IBD see a physician a median of eleven times per year (interquartile range [IQR] 7), with 90% of these visits being related to their IBD (29). Children with IBD visit a doctor more often than children without IBD for at least five years following diagnosis (29).…”

Section: Specialist Care For Ibdmentioning

confidence: 99%

“…Children with IBD see a physician a median of eleven times per year (interquartile range [IQR] 7), with 90% of these visits being related to their IBD (29). Children with IBD visit a doctor more often than children without IBD for at least five years following diagnosis (29).…”

Section: Specialist Care For Ibdmentioning

confidence: 99%

The Impact of Inflammatory Bowel Disease in Canada 2018: Direct Costs and Health Services Utilization

Kuenzig

Benchimol

Lee

et al. 2018

Journal of the Canadian Association of Gastroenterology

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Direct health care costs of illness reflect the costs of medically necessary services and treatments paid for by public and private payers, including hospital-based care, outpatient physician consultations, prescription medications, diagnostic testing, complex continuing care, and home care. The costs of caring for persons with inflammatory bowel disease (IBD) have been rising well above inflation over the past fifteen years in Canada, largely due to the introduction and penetration of expensive biologic therapies. Changing paradigms of care toward frequent patient monitoring and achievement of stricter endpoints for disease control have also increased health services utilization and costs among IBD patients. While the frequency and costs of surgeries and hospitalizations have declined slightly in parallel with increased biologic use (due to better overall disease control), the direct medical costs of care for IBD patients are largely dominated by prescription drug costs. Introduction and penetration of biosimilar agents (at a markedly lower price point than the originator drugs) and increasing gastroenterologist involvement in the care of IBD patients may help to balance rising health care costs while improving health outcomes and quality of life for IBD patients. Ultimately, however, the predicted rise in the prevalence of IBD over the next decade, combined with increasing use of expensive biologic therapies, will likely dictate a continued rise in the direct costs of IBD patient care in Canada for years to come. In 2018, direct health care costs of IBD are estimated to be at least $1 billion Canadian dollars (CAD) and possibly higher than $2 billion CAD. Highlights 1. In Canada, the direct cost of caring for people living with IBD is estimated in 2018 to be close to $1.28 billion (roughly $4731 per person with IBD). 2. The costs of caring for people living with IBD are dominated by prescription drugs, followed by hospitalization costs. There has been a shift away from hospitalizations and toward pharmaceuticals as the predominant driver of direct health care costs in IBD patients, due to the introduction and widespread use of expensive biologic therapies. 3. The rates of hospitalizations and major abdominal surgeries have been declining in IBD patients in Canada over the past two decades, possibly due to penetration of biologic therapies and advances in patient management paradigms. 4. Inflammatory bowel disease patients cared for by gastroenterologists have better outcomes, including lower risks of surgery and hospitalization. Canadians who live in rural and underserviced areas are less likely to receive gastroenterologist care, potentially due to care preferences or poorer access, which may result in poorer long-term outcomes. 5. Introduction of biosimilar agents at a lower price point than originator biologic therapies, increased gastroenterologist care of IBD patients, and improvements in IBD care p...

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“…A recent study from Manitoba showed that the incidence and prevalence of paediatric IBD is on the rise, and hence, economic burden on patients, their families and healthcare system is growing . A significant variability in the healthcare provided to children with IBD among different paediatric centres has been well documented with substantial difference in outcomes among those centres .…”

Section: Details Of Quality Improvement Initiatives In the Paediatricmentioning

confidence: 99%

Quality improvement in paediatric inflammatory bowel disease: the Manitoba experience

El‐Matary

Dufault

2016

Acta Paediatrica

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Health Care Use by a Population-Based Cohort of Children With Inflammatory Bowel Disease

Cited by 18 publications

References 20 publications

High Health Care Utilization Preceding Diagnosis of Systemic Lupus Erythematosus in Youth

High Health Care Utilization Preceding Diagnosis of Systemic Lupus Erythematosus in Youth

The Impact of Inflammatory Bowel Disease in Canada 2018: Direct Costs and Health Services Utilization

Quality improvement in paediatric inflammatory bowel disease: the Manitoba experience

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