Severs Mirjam, Petersen Roosmarijn E, Siersema Peter D, Mangen Marie-Josée J, Oldenburg Bas
*Department of Gastroenterology and Hepatology, University Medical Centre Utrecht, Utrecht, the Netherlands; and †Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht, the Netherlands.
Inflamm Bowel Dis. 2016 Mar;22(3):688-93. doi: 10.1097/MIB.0000000000000643.
Studies on the costs of health care in patients with inflammatory bowel disease (IBD) are increasingly conducted through the collection of self-reported data. We aimed to assess the concordance between estimated annual costs based on self-reported health care utilization and administrative data in IBD.
Consecutive patients with Crohn's disease or ulcerative colitis visiting the outpatient clinic were enrolled. Participants were asked to fill out a questionnaire on their IBD-specific health care utilization over the past year. Registered health care utilization over the same time period was extracted from medical records. Health care resources were multiplied by their unit prices to obtain costs. Cost estimates were compared, and correlation, sensitivity, and specificity were calculated.
In total, 101 patients (70 Crohn's disease, 31 ulcerative colitis) were enrolled. Mean direct health care costs were &OV0556;4758 per year according to self-reported data and &OV0556;4866 according to administrative data (r = 0.97). Hospitalizations and diagnostics were relatively underreported with a sensitivity of 75% and 88%, and a specificity of 100% and 88%, respectively. One of 7 surgical procedures was overreported, and only 1 of 25 patients did not report the use of anti-tumor necrosis factor compounds. Suffering from a flare or having a pouch predicted a decreased recall with an adjusted odds ratio of 3.5 (95% confidence interval, 1.3-9.6) and 10.7 (95% confidence interval, 1.1-107.6), respectively.
We report a high concordance between costs of self-reported health care utilization and administrative data over the past year in IBD. Self-reported health care utilization reliably measures the consumption of health care in IBD.
关于炎症性肠病（IBD）患者医疗保健费用的研究越来越多地通过收集自我报告数据来进行。我们旨在评估基于自我报告的医疗保健利用情况估计的年度费用与IBD行政数据之间的一致性。
纳入连续就诊于门诊的克罗恩病或溃疡性结肠炎患者。参与者被要求填写一份关于过去一年中其IBD特异性医疗保健利用情况的问卷。从医疗记录中提取同一时期登记的医疗保健利用情况。将医疗保健资源乘以其单价以获得费用。比较费用估计值，并计算相关性、敏感性和特异性。
共纳入101例患者（70例克罗恩病，31例溃疡性结肠炎）。根据自我报告数据，每年平均直接医疗保健费用为4758欧元，根据行政数据为4866欧元（r = 0.97）。住院和诊断报告相对不足，敏感性分别为75%和88%，特异性分别为100%和88%。7例手术中有1例报告过多，25例患者中只有1例未报告使用抗肿瘤坏死因子化合物。病情发作或有储袋与回忆减少相关，调整后的优势比分别为3.5（95%置信区间，1.3 - 9.6）和10.7（95%置信区间，1.1 - 107.6）。
我们报告了IBD患者过去一年自我报告的医疗保健利用费用与行政数据之间的高度一致性。自我报告的医疗保健利用情况能够可靠地衡量IBD患者的医疗保健消费。
