S2 Statistical Solutions, Inc., 11176 Main Street, Cincinnati, OH 45241, USA.
Dig Dis Sci. 2012 Dec;57(12):3080-91. doi: 10.1007/s10620-012-2289-y. Epub 2012 Jul 12.
Crohn's disease (CD) and ulcerative colitis (UC) are chronic, debilitating conditions that can have important economic and clinical implications.
To quantify individual and national estimates of the health care and patient out-of-pocket (OOP) costs of CD and UC.
In a retrospective study using 1996 to 2009 data from the Medical Expenditure Panel Survey, individuals' self-reported health conditions were mapped to International Classification of Diseases, Ninth Revision, Clinical Modification diagnostic codes. Individuals with a code of 555.x (CD) or 556.x (UC) were identified. Health care services and costs included prescriptions and inpatient, outpatient, emergency room, office, and home health services. OOP costs were the portion of individuals' total payments for health care services.
There were 358 individuals with CD (mean age 49.0 years; 55 % female), 198 individuals with UC (mean age 47.1 years; 64 % female), and 206,993 individuals without inflammatory bowel disease (IBD) (mean age 48.2 years; 58 % female). Annual per capita health insurer and OOP costs for individuals with CD were greater than those without IBD ($9,526 versus $3,781, p < 0.001 and $1,603 versus $866, p < 0.001, respectively). Health insurer and OOP costs were greater for UC compared with those without IBD ($6,443 versus $3,781, p < 0.001 and $1,263 versus $866, p < 0.001, respectively). US national aggregate annual estimates of health insurer, OOP, and total direct costs secondary to CD are $2.04 billion, $0.26 billion, and $2.29 billion, respectively. Aggregate health insurer, OOP, and total direct costs attributable to UC are $0.53 billion, $0.07 billion, and $0.61 billion, respectively.
The direct costs associated with CD and UC are substantial. The extent to which appropriate diagnosis and treatment reduces the total health care costs for individuals with CD or UC should be examined.
克罗恩病（CD）和溃疡性结肠炎（UC）是慢性、使人虚弱的疾病，会对个人造成重要的经济和临床影响。
量化 CD 和 UC 的个人和国家医疗保健和患者自付（OOP）成本的估计值。
在一项使用 1996 年至 2009 年《医疗支出面板调查》数据的回顾性研究中，根据国际疾病分类，第九版，临床修正诊断代码，将个人自我报告的健康状况映射到诊断代码。确定代码为 555.x（CD）或 556.x（UC）的个体。医疗保健服务和费用包括处方以及住院、门诊、急诊、办公室和家庭保健服务。OOP 费用是个人总医疗保健服务支付额的一部分。
有 358 名 CD 患者（平均年龄 49.0 岁；55%为女性）、198 名 UC 患者（平均年龄 47.1 岁；64%为女性）和 206993 名无炎症性肠病（IBD）患者（平均年龄 48.2 岁；58%为女性）。CD 患者的人均医疗保险和 OOP 年度费用高于无 IBD 患者（9526 美元对 3781 美元，p<0.001 和 1603 美元对 866 美元，p<0.001）。UC 患者的医疗保险和 OOP 费用也高于无 IBD 患者（6443 美元对 3781 美元，p<0.001 和 1263 美元对 866 美元，p<0.001）。美国 CD 的医疗保险、OOP 和总直接成本的年度国家估计值分别为 20.4 亿美元、2.64 亿美元和 22.9 亿美元。UC 的医疗保险、OOP 和总直接成本分别为 5.30 亿美元、7000 万美元和 6.10 亿美元。
与 CD 和 UC 相关的直接成本很高。应检查适当的诊断和治疗在多大程度上降低 CD 或 UC 患者的总医疗保健成本。
