HEALTH CARE UTILIZATION AND ECONOMIC BURDEN OF PATIENTS WITH INFLAMMATORY BOWEL DISEASE IN THE US DEPARTMENT OF DEFENSE POPULATION
Author(s)
Xie L1, Wang Y1, Qiang W1, Sah J1, Yuce H2, Aygenc G3, Baser O4
1STATinMED Research, Ann Arbor, MI, USA, 2New York City College of Technology-CUNY and STATinMED Research, New York, NY, USA, 3STATinMED Research, New York, NY, USA, 4Columbia University and STATinMED Research, New York, NY, USA
OBJECTIVES : Compare health care utilization (HRU) and costs of patients with and without inflammatory bowel disease (IBD) in the US Department of Defense (DoD) population. METHODS : A retrospective data analysis was performed using 100% DoD data from 01OCT2011-30SEPT2016. Adult patients diagnosed with ≥1 IBD claim were identified using International Classification of Diseases, 9th and 10th Revision, Clinical Modification (ICD-9/10-CM) diagnosis codes (ICD-9-CM: 555, 556; ICD-10-CM: K50, K51). The first diagnosis date was designated as the index date. A comparison cohort of patients without IBD diagnosis was created for patients of the same age, sex, race, index year, and similar Charlson comorbidity index (CCI) score. A random index date was chosen for the comparison cohort to reduce selection bias. Patients were required to have continuous medical and pharmacy benefits for 12 months pre- and post-index date. A generalized linear model (GLM) was performed to compare follow-up HRU and costs between the cohorts, adjusting for demographic and clinical characteristics. RESULTS : A total of 12,418 patients were included in each cohort (IBD and comparator cohorts). The mean age was 42 years, and 54% were female. IBD patients had higher CCI scores (0.54 vs 0.49; p<0.001). After balancing for clinical characteristics in the GLM, IBD patients had more inpatient (0.34 vs 0.08; p<0.001), emergency room (ER; 1.03 vs 0.40; p<0.001), ambulatory (30.32 vs 15.23, p<0.001), and pharmacy visits (16.73 vs 8.28, p<0.001), as well as longer hospital length of stay (2.29 vs 0.48 days; p<0.001) compared to patients in the comparator cohort. IBD patients also incurred significantly higher inpatient ($3,936 vs $932; p<0.001), ER ($799 vs $253; p<0.001), ambulatory ($11,753 vs $4,032; p<0.001), pharmacy ($3,549 vs $655; p<0.001), and total ($20,025 vs $5,889; p<0.0001) costs. CONCLUSIONS : DoD beneficiaries diagnosed with IBD incurred higher HRU and costs relative to comparator patients.
Conference/Value in Health Info
2018-05, ISPOR 2018, Baltimore, MD, USA
Value in Health, Vol. 21, S1 (May 2018)
Code
PGI32
Topic
Economic Evaluation
Topic Subcategory
Cost/Cost of Illness/Resource Use Studies
Disease
Gastrointestinal Disorders