Prevalence and Financial Burden of Digestive Diseases in a Commercially Insured Population - PubMed (original) (raw)

. 2022 Jul;20(7):1480-1487.e7.

doi: 10.1016/j.cgh.2021.06.047. Epub 2021 Jul 1.

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Prevalence and Financial Burden of Digestive Diseases in a Commercially Insured Population

Simon C Mathews et al. Clin Gastroenterol Hepatol. 2022 Jul.

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Abstract

Background & aims: Digestive diseases represent a diverse group of clinical conditions that impact the population. Their heterogeneity in classification, presentation, acuity, chronicity, and need for drug therapy presents a challenge when comparing and contrasting the burden associated with these conditions. Prior studies use an outdated classification system and aggregate costs at the population level or focus on specific diseases, limiting the ability to characterize the overall landscape. Our aim was to provide the most up-to-date assessment of cost, utilization, and prevalence associated with digestive diseases.

Methods: We examined digestive disease claims and payment data for a commercially insured adult population between 2016 and 2018 to provide a comprehensive summary of costs, utilization, and prevalence across 38 conditions. Outcome variables included point prevalence and relative prevalence, annualized all-cause medical and drug costs, digestive disease-specific average medical cost, digestive disease-specific cost per fill, and utilization by clinical setting and by clinical condition.

Results: A total of 7,297,435 individuals with a digestive disease diagnosis were included in the study. The point prevalence of having a digestive disease in the total population was 24%. Annualized total costs by clinical category ranged from 10,038(eosinophilicesophagitis)to10,038 (eosinophilic esophagitis) to 10,038(eosinophilicesophagitis)to107,007 (hepatitis C), with medical costs accounting for most of the expenditures in a majority of conditions. Annualized total costs for common conditions included 39,653foralcoholicliverdisease,39,653 for alcoholic liver disease, 39,653foralcoholicliverdisease,42,554 for acute pancreatitis, 62,735forCrohn′sdisease,62,735 for Crohn's disease, 62,735forCrohn′sdisease,13,948 for functional gastrointestinal disorders, 53,214fornonalcoholiccirrhosis,and53,214 for nonalcoholic cirrhosis, and 53,214fornonalcoholiccirrhosis,and36,441 for ulcerative colitis. Average cost of inpatient stays ranged from 12,218(noninfectiousgastroenteritis/colitis)to12,218 (noninfectious gastroenteritis/colitis) to 12,218(noninfectiousgastroenteritis/colitis)to78,259 (nonalcoholic steatohepatitis). Outpatient visits ranged from 784(gastrointestinalinfection)to784 (gastrointestinal infection) to 784(gastrointestinalinfection)to4629 (gallbladder and biliary tract disease). Average drug cost per fill ranged from 83(gastroesophagealrefluxdisease)to83 (gastroesophageal reflux disease) to 83(gastroesophagealrefluxdisease)to1458 (hepatitis C). A total of 27,429,046 clinical encounters occurred across all conditions during the study period, with 90% taking place as outpatient visits. Abdominal pain was the single largest contributor to outpatient visits and emergency department to home encounters. Inpatient stays were considerably more heterogeneous, with no condition accounting for more than 12% (gallbladder and biliary tract disease) of the total.

Conclusions: The results demonstrate digestive diseases are common, heterogeneous in cost and utilization, and collectively exact a significant financial burden on the U.S. adult population.

Keywords: Financial Burden; Healthcare Cost; Healthcare Utilization; Prevalence.

Copyright © 2022 The Authors. Published by Elsevier Inc. All rights reserved.

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