Medical costs in community subjects with irritable bowel syndrome.

BACKGROUND & AIMS Costs of management of irritable bowel syndrome (IBS) are unknown. The direct medical charges in community subjects with IBS were estimated. METHODS An age- and sex-stratified random sample of residents of Olmsted County, Minnesota, ranging in age from 20 to 95 years, was mailed a valid self-report questionnaire. Subjects were categorized as having IBS, having some symptoms but inadequate criteria for IBS, and controls. All charges (in 1992 U.S. dollars) for health services rendered in the year before completing the survey were obtained (except outpatient medications). RESULTS A total of 88% of subjects with IBS, 86% of subjects with some symptoms of IBS, and 83% of controls incurred direct medical charges during the study year. The odds of incurring charges were 1.6 times greater in subjects with IBS relative to those without symptoms (P < 0.01) adjusting for age, sex, education, marital status, and employment. Overall median charges incurred by subjects with IBS were $742 compared with $429 for controls and $614 for subjects with some symptoms. Among those subjects with nonzero charges, there were significant positive associations with age, higher education, and symptom groups (all P < 0.01) but not sex. CONCLUSIONS The economic impact of IBS is significant. A better understanding of the determinants of these costs is needed so that cost-saving strategies can be implemented.

[1]  Evans Rw,et al.  An economic analysis of liver transplantation. Costs, insurance coverage, and reimbursement. , 1993 .

[2]  L. Greenwald,et al.  U.S. health expenditure performance: An international comparison and data update , 1992, Health care financing review.

[3]  A. Zinsmeister,et al.  A patient questionnaire to identify bowel disease. , 1989, Annals of internal medicine.

[4]  C. Schramm.  Health care and its costs , 1987 .

[5]  L. D. O'Donnell,et al.  Symptoms of irritable bowel syndrome in a British urban community: consulters and nonconsulters. , 1992, Gastroenterology.

[6]  K. Heaton,et al.  Towards positive diagnosis of the irritable bowel. , 1978, British medical journal.

[7]  A R Zinsmeister,et al.  Epidemiology of colonic symptoms and the irritable bowel syndrome. , 1991, Gastroenterology.

[8]  S. Finkler.  The distinction between cost and charges. , 1982, Annals of internal medicine.

[9]  L. Melton,et al.  Diagnostic value of the Manning criteria in irritable bowel syndrome. , 1990, Gut.

[10]  Predicting hospital accounting costs , 1990, Health care financing review.

[11]  Evans Rw.  The socioeconomics of organ transplantation. , 1985 .

[12]  E. Tangalos,et al.  A bowel symptom questionnaire for the elderly. , 1992, Journal of gerontology.

[13]  E. Keeler,et al.  Costing Medical Care: Using Medicare Administrative Data , 1994, Medical care.

[14]  N. Talley.  Diagnosing an irritable bowel: does sex matter? , 1991, Gastroenterology.

[15]  Philip Jacobs,et al.  The economics of health and medical care , 1987 .

[16]  G. Lundberg.  Costs, charges, conscience, and control (lost) , 1983, JAMA.

[17]  K. Price.  Pricing Medicare's diagnosis-related groups: Charges versus estimated costs , 1989, Health care financing review.

[18]  D. M. Switz.  What the gastroenterologist does all day. A survey of a state society's practice. , 1976, Gastroenterology.

[19]  D. Ballard,et al.  The Olmsted County Benchmark Project: primary study findings and potential implications for corporate America. , 1992, Mayo Clinic proceedings.

[20]  S. Gabriel,et al.  The health care costs of nonsteroidal anti-inflammatory drug-related gastric ulcer in Olmsted County, MN, 1987-1990 , 1992 .

[21]  C. M. Mitchell,et al.  Survey of the AGA membership relating to patients with functional gastrointestinal disorders. , 1987, Gastroenterology.

[22]  D. Rublee,et al.  International health spending: comparisons with the OECD. , 1991, Health affairs.

[23]  R. Harvey,et al.  PROGNOSIS IN THE IRRITABLE BOWEL SYNDROME: A 5-YEAR PROSPECTIVE STUDY , 1987, The Lancet.

[24]  G. Locke,et al.  Digestive diseases in the United States: Epidemiology and impact: Edited by James E. Everhart. 799 pp. $15.00. National Digestive Diseases Information Clearinghouse, Bethesda, Maryland, 1994. NIH Publication No. 94-1447 , 1995 .

[25]  L. Kurland,et al.  The patient record in epidemiology. , 1981, Scientific American.

[26]  R. Sandler.  Epidemiology of irritable bowel syndrome in the United States. , 1990, Gastroenterology.

[27]  Evans Rw.  Organ transplantation costs, insurance coverage, and reimbursement. , 1990 .

[28]  B. Culliton,et al.  Post-marketing surveillance. , 1980, British medical journal.

[29]  D. McKusick,et al.  National health expenditures projections through 2030 , 1992, Health care financing review.

[30]  L. Iezzoni.  Risk Adjustment for Measuring Healthcare Outcomes , 1994 .

[31]  Roger Jones,et al.  Irritable bowel syndrome in the general population. , 1992, BMJ.

[32]  R. Evans.  Cost-effectiveness analysis of transplantation. , 1986, The Surgical clinics of North America.

[33]  D. Commerce.  Statistical abstract of the United States , 1978 .