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肠易激症状、医疗保健使用、成本、疾病和残疾抚恤金:一项长期的基于人群的研究。

Irritable bowel symptoms, use of healthcare, costs, sickness and disability pension benefits: A long-term population-based study.

机构信息

Research Centre for Prevention and Health, Capital Region of Denmark, Denmark.

Copenhagen University Hospital, Mental Health Centre Copenhagen, Denmark.

出版信息

Scand J Public Health. 2019 Dec;47(8):867-875. doi: 10.1177/1403494818776168. Epub 2018 May 15.

DOI:10.1177/1403494818776168
PMID:29762084
Abstract

Irritable bowel syndrome (IBS) is associated with increased healthcare use and work absenteeism. We aimed to investigate long-term use of healthcare services and social benefits across IBS symptom groups. Additionally, we estimated excess healthcare costs. A longitudinal population-based study comprising two 5-year follow-up studies: The Danish part of the Multinational Monitoring of Trends and Determinants in Cardiovascular Disease (Dan-MONICA) 1 (1982-1987) and Inter99 (1999-2004) recruited from the western part of Copenhagen County. The total study population ( = 7278) was divided into symptom groups according to degree of IBS definition fulfillment at baseline and/or 5-year follow-up and was followed until 31 December 2013 in Danish central registries. Poisson regression was used for the analyses adjusting for age, sex, length of education, comorbidity, cohort membership and mental vulnerability. IBS symptom groups compared to no IBS symptoms were associated with an increased number of contacts with primary and secondary healthcare, as well as weeks on sickness and disability benefits. Accounting for mental vulnerability decreased the estimates and all but two associations between IBS symptom groups and outcomes remained statistically significant. The two associations that became insignificant were contacts with psychiatric hospitals and weeks on disability pension. The excess unadjusted healthcare costs for IBS were 680 Euros per year and the overall association between symptom groups and total healthcare costs were statistically significant.

摘要

肠易激综合征(IBS)与增加医疗保健使用和旷工有关。我们旨在研究 IBS 症状组之间的长期医疗保健服务和社会福利的使用情况。此外,我们还估计了过度的医疗保健费用。一项基于人群的纵向研究,包括两项为期 5 年的随访研究:丹麦部分多国监测趋势和心血管疾病决定因素(Dan-MONICA)1(1982-1987 年)和 Inter99(1999-2004 年),从哥本哈根县西部招募。总研究人群(n=7278)根据基线和/或 5 年随访时 IBS 定义的满足程度分为症状组,并在丹麦中央登记处随访至 2013 年 12 月 31 日。采用泊松回归进行分析,调整年龄、性别、教育年限、合并症、队列成员和心理脆弱性。与无 IBS 症状相比,IBS 症状组与初级和二级医疗保健的就诊次数以及病假和残疾津贴周数增加有关。考虑到心理脆弱性,估计值降低,除了两个 IBS 症状组与结果之间的关联外,所有关联均具有统计学意义。两个变得不显著的关联是与精神病院的接触和残疾抚恤金周数。未经调整的 IBS 医疗保健费用每年为 680 欧元,症状组与总医疗保健费用之间的总体关联具有统计学意义。

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