RTI Health Solutions, Research Triangle Park, NC, USA.
Postgrad Med. 2011 May;123(3):122-32. doi: 10.3810/pgm.2011.05.2290.
Chronic idiopathic constipation and irritable bowel syndrome (IBS) are common gastrointestinal conditions with potentially significant burden on managed care systems. Our objective was to examine all-cause resource utilization and charges associated with constipation alone (C-only) and with IBS with comorbid constipation (IBS+C).
Administrative claims from a US health plan between January 1, 2003 and December 31, 2005 were analyzed. Patients with C-only (n = 48 585) and IBS+C (n = 10 952) were identified using International Classification of Diseases, 9th Revision, Clinical Modification diagnosis codes. Outcomes were compared with demographically matched controls and with a benchmark group of patients with migraine (N = 48 759). An index date was defined as the date 3 months prior to first observed diagnosis of the condition of interest. Outcomes were evaluated over a 12-month period before and after the index date.
The pre-to-post increase in total charges for subjects with C-only was substantially higher than that for the comparison group ($8837 vs $1717; P < 0.001) or the migraine group ($8837 vs $ 4804; P < 0.001). Subjects with IBS+C also had a greater pre-to-post increase in total charges than did comparison group members ($6192 vs $1319; P < 0.001) and subjects with migraine ($6192 vs $4804; P = 0.0120).
Both C-only and IBS+C impose substantial economic burden on third-party payers.
慢性特发性便秘和肠易激综合征（IBS）是常见的胃肠道疾病，对管理式医疗保健系统有潜在的重大影响。我们的目的是研究单独便秘（C 组）和伴有便秘的 IBS（IBS+C 组）相关的所有原因资源利用和费用。
分析了美国健康计划在 2003 年 1 月 1 日至 2005 年 12 月 31 日期间的行政索赔数据。使用国际疾病分类，第 9 修订版，临床修正诊断代码识别 C 组（n = 48585）和 IBS+C 组（n = 10952）患者。结果与人口统计学匹配的对照组和偏头痛基准组（n = 48759）进行了比较。索引日期定义为首次观察到感兴趣疾病的前 3 个月。在索引日期前后的 12 个月内评估了结果。
与对照组（$8837 与$1717；P<0.001）或偏头痛组（$8837 与$4804；P<0.001）相比，C 组患者的总费用在预后期的增长明显更高。与对照组相比（$6192 与$1319；P<0.001）和偏头痛组患者（$6192 与$4804；P = 0.0120）相比，IBS+C 组患者的总费用也有更大的预后期增长。
C 组和 IBS+C 组均对第三方支付者造成了巨大的经济负担。
