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- Title
Direct health-care cost utilization in Hong Kong inflammatory bowel disease patients in the initial 2 years following diagnosis.
- Authors
Mak, Lung‐Yi; Ng, Siew C.; Wong, Irene O. L.; Li, Michael K. K.; Lo, F. H.; Wong, Marc T. L.; Leung, C. M.; Tsang, Steven W. C.; Chan, K. H.; Sze, S. F.; Shan, Edwin H. S.; Lam, Belsy C. Y.; Hui, Aric J.; Hung, Ivan F. N.; Leung, Wai K.
- Abstract
Background and Aim There are scanty data on the health-care utilization from Asia where the incidence of inflammatory bowel disease (IBD) is rising rapidly. We aim to determine the direct health-care costs in the first 2 years of diagnosis in an IBD cohort from Hong Kong and the factors associated with high cost outliers. Methods This is a retrospective cohort study that included patients newly diagnosed with IBD in a territory-wide IBD registry. Patients' clinical information, hospitalization records, investigations, and IBD treatments were retrieved for up to 2 years following diagnosis of IBD. Results Four hundred and thirty-five newly diagnosed IBD patients were included: 198 with Crohn's disease and 237 with ulcerative colitis. Total direct medical expenditure for this cohort 2 years after the IBD diagnosis was $7 072 710: hospitalizations (33%), 5-aminosalicylic acid (23%), imaging and endoscopy (17%), outpatient visits (10%), surgery (8%), and biologics (6%). Mean direct medical costs per patient-year were significantly higher for Crohn's disease ($9918) than ulcerative colitis ($6634; P, 0.001). The total direct health-care cost decreased significantly after transition to the second year ( P < 0.01). High cost (> 90th percentile) outliers were associated with surgery (OR 7.1, 95% CI 2.9-17.2) and low hemoglobin on presentation (OR 0.83, 95% CI 0.70-0.96). Conclusions Hospitalization and 5-aminosalicylic acid usage accounted for 56% of total direct medical costs in the first 2 years of our newly diagnosed IBD patients. Direct health-care costs were higher in the first year compared with the second year of diagnosis. Surgery and low hemoglobin on presentation were associated with high cost outliers.
- Subjects
MEDICAL care costs; MEDICAL economics; INFLAMMATORY bowel diseases; CROHN'S disease; ULCERATIVE colitis
- Publication
Journal of Gastroenterology & Hepatology, 2018, Vol 33, Issue 1, p141
- ISSN
0815-9319
- Publication type
Article
- DOI
10.1111/jgh.13817