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Article: Direct Health Care Cost Utilization in Hong Kong Inflammatory Bowel Disease Patients in the Initial 2 Years Following Diagnosis

TitleDirect Health Care Cost Utilization in Hong Kong Inflammatory Bowel Disease Patients in the Initial 2 Years Following Diagnosis
Authors
KeywordsCrohn's disease
Health economics
Inflammatory bowel disease
Surgery
Ulcerative colitis
Issue Date2018
PublisherWiley-Blackwell Publishing Asia. The Journal's web site is located at http://www.blackwellpublishing.com/journals/JGH
Citation
Journal of Gastroenterology and Hepatology, 2018, v. 33 n. 1, p. 141-149 How to Cite?
AbstractBackground and Aim: There are scanty data on the health-care utilization from Asia where the incidence of inflammatory bowel disease (IBD) is rising rapidly. We aim to determine the direct health-care costs in the first 2 years of diagnosis in an IBD cohort from Hong Kong and the factors associated with high cost outliers. Methods: This is a retrospective cohort study that included patients newly diagnosed with IBD in a territory-wide IBD registry. Patients' clinical information, hospitalization records, investigations, and IBD treatments were retrieved for up to 2 years following diagnosis of IBD. Results: Four hundred and thirty-five newly diagnosed IBD patients were included: 198 with Crohn's disease and 237 with ulcerative colitis. Total direct medical expenditure for this cohort 2 years after the IBD diagnosis was $7 072 710: hospitalizations (33%), 5-aminosalicylic acid (23%), imaging and endoscopy (17%), outpatient visits (10%), surgery (8%), and biologics (6%). Mean direct medical costs per patient-year were significantly higher for Crohn's disease ($9918) than ulcerative colitis ($6634; P, 0.001). The total direct health-care cost decreased significantly after transition to the second year (P < 0.01). High cost (> 90th percentile) outliers were associated with surgery (OR 7.1, 95% CI 2.9–17.2) and low hemoglobin on presentation (OR 0.83, 95% CI 0.70–0.96). Conclusions: Hospitalization and 5-aminosalicylic acid usage accounted for 56% of total direct medical costs in the first 2 years of our newly diagnosed IBD patients. Direct health-care costs were higher in the first year compared with the second year of diagnosis. Surgery and low hemoglobin on presentation were associated with high cost outliers. © 2017 Journal of Gastroenterology and Hepatology Foundation and John Wiley & Sons Australia, Ltd
Persistent Identifierhttp://hdl.handle.net/10722/242855
ISSN
2017 Impact Factor: 3.483
2015 SCImago Journal Rankings: 1.190
ISI Accession Number ID

 

DC FieldValueLanguage
dc.contributor.authorMak, LY-
dc.contributor.authorNg, SC-
dc.contributor.authorWong, OL-
dc.contributor.authorLi, MKK-
dc.contributor.authorLo, FH-
dc.contributor.authorWong, MTL-
dc.contributor.authorLeung, CM-
dc.contributor.authorTsang, SWC-
dc.contributor.authorChan, KH-
dc.contributor.authorSze, SF-
dc.contributor.authorShan, EHS-
dc.contributor.authorLam, EHS-
dc.contributor.authorHui, AJ-
dc.contributor.authorHung, FNI-
dc.contributor.authorLeung, WK-
dc.date.accessioned2017-08-25T02:46:18Z-
dc.date.available2017-08-25T02:46:18Z-
dc.date.issued2018-
dc.identifier.citationJournal of Gastroenterology and Hepatology, 2018, v. 33 n. 1, p. 141-149-
dc.identifier.issn0815-9319-
dc.identifier.urihttp://hdl.handle.net/10722/242855-
dc.description.abstractBackground and Aim: There are scanty data on the health-care utilization from Asia where the incidence of inflammatory bowel disease (IBD) is rising rapidly. We aim to determine the direct health-care costs in the first 2 years of diagnosis in an IBD cohort from Hong Kong and the factors associated with high cost outliers. Methods: This is a retrospective cohort study that included patients newly diagnosed with IBD in a territory-wide IBD registry. Patients' clinical information, hospitalization records, investigations, and IBD treatments were retrieved for up to 2 years following diagnosis of IBD. Results: Four hundred and thirty-five newly diagnosed IBD patients were included: 198 with Crohn's disease and 237 with ulcerative colitis. Total direct medical expenditure for this cohort 2 years after the IBD diagnosis was $7 072 710: hospitalizations (33%), 5-aminosalicylic acid (23%), imaging and endoscopy (17%), outpatient visits (10%), surgery (8%), and biologics (6%). Mean direct medical costs per patient-year were significantly higher for Crohn's disease ($9918) than ulcerative colitis ($6634; P, 0.001). The total direct health-care cost decreased significantly after transition to the second year (P < 0.01). High cost (> 90th percentile) outliers were associated with surgery (OR 7.1, 95% CI 2.9–17.2) and low hemoglobin on presentation (OR 0.83, 95% CI 0.70–0.96). Conclusions: Hospitalization and 5-aminosalicylic acid usage accounted for 56% of total direct medical costs in the first 2 years of our newly diagnosed IBD patients. Direct health-care costs were higher in the first year compared with the second year of diagnosis. Surgery and low hemoglobin on presentation were associated with high cost outliers. © 2017 Journal of Gastroenterology and Hepatology Foundation and John Wiley & Sons Australia, Ltd-
dc.languageeng-
dc.publisherWiley-Blackwell Publishing Asia. The Journal's web site is located at http://www.blackwellpublishing.com/journals/JGH-
dc.relation.ispartofJournal of Gastroenterology and Hepatology-
dc.subjectCrohn's disease-
dc.subjectHealth economics-
dc.subjectInflammatory bowel disease-
dc.subjectSurgery-
dc.subjectUlcerative colitis-
dc.titleDirect Health Care Cost Utilization in Hong Kong Inflammatory Bowel Disease Patients in the Initial 2 Years Following Diagnosis-
dc.typeArticle-
dc.identifier.emailWong, OL: iolwong@hku.hk-
dc.identifier.emailHung, FNI: ivanhung@hkucc.hku.hk-
dc.identifier.emailLeung, WK: hku75407@hku.hk-
dc.identifier.authorityWong, OL=rp01806-
dc.identifier.authorityHung, FNI=rp00508-
dc.identifier.authorityLeung, WK=rp01479-
dc.description.naturelink_to_subscribed_fulltext-
dc.identifier.doi10.1111/jgh.13817-
dc.identifier.pmid28475813-
dc.identifier.scopuseid_2-s2.0-85039429971-
dc.identifier.hkuros273706-
dc.identifier.volume33-
dc.identifier.issue1-
dc.identifier.spage141-
dc.identifier.epage149-
dc.identifier.isiWOS:000419097500019-
dc.publisher.placeAustralia-

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