Service de Gastroentérologie, Hôpital Avicenne AP-HP, INSERM U-987, 175 rue de Stalingrad, 93000, Bobigny, France.
Physiopathologie et Pharmacologie Clinique de la Douleur, Hôpital Ambroise Paré, 9 avenue Charles-de-Gaulle, 92104, Boulogne-Billancourt, France.
BMC Gastroenterol. 2019 Jun 27;19(1):111. doi: 10.1186/s12876-019-1031-z.
Irritable bowel syndrome (IBS) can be responsible for alteration in quality of life and economic burden. The aim of this study was to evaluate healthcare use related to this disorder in France.
The French health data system was used to select adults covered by the general health scheme (87% of population) through their first IBS hospitalization in 2015. We studied the healthcare refunded during the previous 5 years, 1 year before and after hospitalization.
Among 43.7 million adults who used refunded healthcare in 2015, 29,509 patients were identified (0.07, 33% males, 67% females, mean age 52 years, 30% admitted through emergency room). During their hospitalization, 33% had upper endoscopy and 64% colonoscopy. Over the five previous years, 3% had at least one hospitalization with an IBS diagnosis, 58% had abdominal ultrasonography, 27% CT scan, 21% upper endoscopy, 13% colonoscopy and 83% a gastroenterologist visit. The year before, these rates were respectively: 0, 36, 16, 6, 4 and 78%. Some of those rates decreased the year after the hospitalization with respectively: 1, 27, 13, 5, 4 and 19%. The year before, 65% had at least one CRP dosage (13% three or more), 58% a TSH dosage (7%) and 8% a test for coeliac diseases (1%) and the year after: 44% (8%), 43% (5%) and 3% (0.3%). At least one refund of a drug used to treat IBS was found for 85% of patients 5 years before, 65% one year before and 51% one year after.
This first study using French health data system for healthcare consumption assessment in IBS points out the repetition of outpatient visits, examinations and in particular radiological examinations, without a strong decrease after hospitalization for IBS and gastroenterologist visit.
肠易激综合征（IBS）可导致生活质量下降和经济负担增加。本研究旨在评估法国与该疾病相关的医疗保健使用情况。
利用法国健康数据系统，通过 2015 年首次 IBS 住院治疗，选择参加全民健康保险计划的成年人（占总人口的 87%）。我们研究了住院前 5 年、前 1 年和后 1 年期间报销的医疗保健情况。
在 2015 年使用报销医疗保健的 4370 万成年人中，共发现 29509 例患者（0.07%为男性，67%为女性，平均年龄 52 岁，30%通过急诊室入院）。在住院期间，33%接受了上消化道内镜检查，64%接受了结肠镜检查。在过去的五年中，3%至少有一次 IBS 诊断的住院治疗，58%接受了腹部超声检查，27%接受了 CT 扫描，21%接受了上消化道内镜检查，13%接受了结肠镜检查，83%接受了胃肠病学家的就诊。前一年，这些比率分别为：0、36、16、6、4 和 78%。住院后，这些比率分别下降：1、27、13、5、4 和 19%。前一年，65%至少进行过一次 CRP 检测（13%进行了三次或更多次检测），58%进行了 TSH 检测（7%），8%进行了乳糜泻检测（1%），后一年，分别为 44%（8%）、43%（5%）和 3%（0.3%）。在 IBS 住院前 5 年，85%的患者至少有一次报销用于治疗 IBS 的药物，前 1 年为 65%，前 1 年为 51%。
这是首次使用法国健康数据系统评估 IBS 医疗保健消费的研究，指出了门诊就诊、检查，特别是放射检查的重复，而 IBS 和胃肠病学家就诊后并没有明显减少。
