University of North Carolina School of Medicine, Chapel Hill, North Carolina.
University of North Carolina School of Medicine, Chapel Hill, North Carolina.
Gastroenterology. 2015 Dec;149(7):1731-1741.e3. doi: 10.1053/j.gastro.2015.08.045. Epub 2015 Aug 29.
BACKGROUND & AIMS: Gastrointestinal (GI), liver, and pancreatic diseases are a source of substantial morbidity, mortality, and cost in the United States. Quantification and statistical analyses of the burden of these diseases are important for researchers, clinicians, policy makers, and public health professionals. We gathered data from national databases to estimate the burden and cost of GI and liver disease in the United States.
We collected statistics on health care utilization in the ambulatory and inpatient setting along with data on cancers and mortality from 2007 through 2012. We included trends in utilization and charges. The most recent data were obtained from the Centers for Disease Control and Prevention, the Agency for Healthcare Research and Quality, and the National Cancer Institute.
There were 7 million diagnoses of gastroesophageal reflux and almost 4 million diagnoses of hemorrhoids in the ambulatory setting in a year. Functional and motility disorders resulted in nearly 1 million emergency department visits in 2012; most of these visits were for constipation. GI hemorrhage was the most common diagnosis leading to hospitalization, with >500,000 discharges in 2012, at a cost of nearly $5 billion dollars. Hospitalizations and associated charges for inflammatory bowel disease, Clostridium difficile infection, and chronic liver disease have increased during the last 20 years. In 2011, there were >1 million people in the United States living with colorectal cancer. The leading GI cause of death was colorectal cancer, followed by pancreatic and hepatobiliary neoplasms.
GI, liver and pancreatic diseases are a source of substantial burden and cost in the United States.
在美国，胃肠道（GI）、肝脏和胰腺疾病是导致发病率、死亡率和医疗费用高的主要原因。对这些疾病的负担进行量化和统计分析对于研究人员、临床医生、政策制定者和公共卫生专业人员都非常重要。我们从国家数据库中收集数据，以估计美国胃肠道和肝脏疾病的负担和成本。
我们收集了 2007 年至 2012 年门诊和住院患者的医疗保健利用情况以及癌症和死亡率数据。我们包括了利用和收费的趋势。最新数据来自疾病控制与预防中心、医疗保健研究与质量局和国家癌症研究所。
在一年的门诊中，有 700 万例胃食管反流病和近 400 万例痔疮的诊断。功能性和运动障碍导致 2012 年近 100 万次急诊就诊；其中大多数就诊是因为便秘。胃肠道出血是导致住院的最常见诊断，2012 年有超过 50 万例出院，费用接近 50 亿美元。过去 20 年来，炎症性肠病、艰难梭菌感染和慢性肝病的住院治疗和相关费用有所增加。2011 年，美国有超过 100 万人患有结直肠癌。胃肠道疾病导致死亡的主要原因是结直肠癌，其次是胰腺癌和肝胆肿瘤。
在美国，胃肠道、肝脏和胰腺疾病是一个负担沉重且费用高昂的问题。
