Utilization of Healthcare Resources by U.S. Children and Adults with Inflammatory Bowel Disease
Utilization of Healthcare Resources by U.S. Children and Adults with Inflammatory Bowel Disease
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DOI：
10.1002/ibd.21371
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发表时间：
2011-01-01
影响因子：
4.9
通讯作者：
Finkelstein, Jonathan A.
中科院分区：
文献类型：
--
作者：
Kappelman, Michael D.;Porter, Carol Q.;Finkelstein, Jonathan A.
背景资料：炎症性肠病（IBD）、克罗恩病（CD）和溃疡性结肠炎（UC）影响美国超过100万人，但对受影响个体的医疗保健利用知之甚少。目的是描述在一个有保险的美国，与IBD相关的医疗保健利用。S.人口，并确定社会人口因素如何影响医疗保健利用在这个population.Methods：使用一个行政数据库，包括87个健康计划，我们确定的CD和UC的情况下，使用行政定义。我们确定了2003-2004年IBD患者和匹配对照组的住院、办公室、急诊（艾德）和内镜服务。对于每例病例，通过从病例访视次数中减去对照访视的平均次数来确定过量使用。多元逻辑和线性回归被用来确定与过度utilization.Results相关的社会人口因素：我们确定了9056 CD患者和10,364 UC患者。每100例CD患者的年平均额外住院、艾德访视和门诊访视次数分别为21.7、20.1和493。UC的这些值分别为13.3、10.3和364。总体而言，CD患者的利用率高于UC患者，年轻患者的利用率高于老年患者。利用率也因性别、地理区域和保险类型（医疗保险与商业保险）而异。美国，IBD患者消耗大量的医疗资源。资源利用因患者年龄和疾病类型而异，在较小程度上，性别，地理区域和保险类型也不同。这些发现可用于为卫生政策提供信息。
Background: The inflammatory bowel diseases (IBDs) Crohn's disease (CD) and ulcerative colitis (UC) affect over 1 million people in the United States, yet little is known about healthcare utilization by affected individuals. The objectives were to describe the healthcare utilization associated with IBD in an insured U. S. population and to determine how sociodemographic factors impact healthcare utilization in this population.Methods: Using an administrative database comprised of 87 health plans, we ascertained cases of CD and UC using an administrative definition. We identified inpatient, office-based, emergency (ED), and endoscopy services occurring between 2003-2004 in IBD patients and matched controls. For each case, excess utilization was determined by subtracting the mean number of control visits from the number of case visits. Multivariate logistic and linear regressions were used to identify the sociodemographic factors associated with excess utilization.Results: We identified 9056 CD patients and 10,364 UC patients. The mean number of annual excess hospitalizations, ED visits, and office visits per 100 patients for CD were 21.7, 20.1, and 493, respectively. These values for UC were 13.3, 10.3, and 364, respectively. In general, utilization was higher in CD compared with UC, and in younger patients compared with older patients. Utilization also varied by gender, geographical region, and insurance type (Medicaid versus commercial).Conclusions: In the U. S., patients with IBD consume substantial healthcare resources. Resource utilization varies by patient age and disease type, and to a lesser extent, gender, geographical region, and insurance type. These findings may be used to inform health policy.