Department of Internal Medicine, Max Rady College of Medicine, Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, MB, Canada.
University of Manitoba IBD Clinical and Research Centre, Winnipeg, MB, Canada.
Inflamm Bowel Dis. 2022 Aug 1;28(8):1189-1197. doi: 10.1093/ibd/izab248.
We aimed to determine both direct (medical) and indirect (lost wages) costs of IBD and the association between the degree of IBD-related disability and extent of IBD-related costs.
Persons age 18-65 from the population-based University of Manitoba IBD Research Registry completed a survey including the IBD Disability Index (IBDDI) and questions related to employment, missed work (absenteeism), and reduced productivity at work (presenteeism). Administrative health data including surgeries, hospitalizations, physician claims, and prescriptions were linked to the survey and assessed. To calculate annual wage loss, number of days of missed work was multiplied by the average wage in Manitoba for the given occupation per Statistics Canada. Costs were adjusted to 2016-17 Canadian dollars. Using descriptive and regression analysis, we explored the association between IBDDI and annual direct and indirect costs associated with IBD.
Average annual medical costs rose from $1918 among those with IBDDI 0-4 to $9,993 among those with IBDDI 80-86. Average annual cost of lost work rose from $0 among those with IBDDI 0-4 to $30,101 among those with IBDDI 80-86. Using linear regression, each additional unit of IBDDI was associated with an increase of $77 in annual medical cost (95% CI, $52-102; P < .001) and an increase of $341 in annual cost of lost wages (95% CI, $288-395; P < .001).
Costs related to IBD are significantly associated with the degree of IBD-related disability. Among the approximate 30% of the IBD population with IBDDI scores ≥40, the indirect costs of absenteeism and presenteeism accounts for ~75% of the total IBD-related costs.
本研究旨在确定炎症性肠病（IBD）的直接（医疗）和间接（工资损失）成本，并探讨 IBD 相关残疾程度与 IBD 相关成本之间的关系。
来自基于人群的曼尼托巴大学 IBD 研究注册中心的 18-65 岁人群完成了一项调查，内容包括 IBD 残疾指数（IBDDI）以及与就业、旷工（缺勤）和工作效率降低（在职）相关的问题。将行政健康数据（包括手术、住院、医生索赔和处方）与调查结果相关联并进行评估。为了计算年度工资损失，旷工天数乘以加拿大统计局给出的曼尼托巴省特定职业的平均工资。成本根据 2016-17 年加拿大元进行调整。使用描述性和回归分析，我们探讨了 IBDDI 与 IBD 相关的直接和间接年度成本之间的关系。
IBDDI 为 0-4 的患者的平均年医疗费用为 1918 加元，而 IBDDI 为 80-86 的患者的平均年医疗费用为 9993 加元。IBDDI 为 0-4 的患者的平均年工作损失成本为 0，而 IBDDI 为 80-86 的患者的平均年工作损失成本为 30101 加元。使用线性回归，IBDDI 每增加一个单位，与年度医疗费用增加 77 加元（95%CI，52-102；P<.001）和年度工资损失成本增加 341 加元（95%CI，288-395；P<.001）相关。
与 IBD 相关的成本与 IBD 相关残疾程度显著相关。在 IBDDI 评分≥40 的 IBD 人群中，约有 30%的患者的旷工和在职缺勤的间接成本占 IBD 相关总成本的~75%。
