Determinants of direct and indirect costs in anorexia nervosa. Issue 1 (17th March 2014)

• Record Type: Journal Article
• Authors: Stuhldreher, Nina; Wild, Beate; König, Hans‐Helmut; Konnopka, Alexander; Zipfel, Stephan; Herzog, Wolfgang
• Is Part Of: International journal of eating disorders. Volume 48:Issue 1(2015:Jan.)
• Page Start: 139
• Page End: 146
• Publication Date: 2014-03-17
• Subjects: Appetite disorders -- Periodicals; Ingestion disorders -- Periodicals; Eating disorders -- Periodicals; 616.8526
• DOI: 10.1002/eat.22274
• Languages: English
• ISSNs: 0276-3478

Abstract

<abstract abstract-type="main"> <title>ABSTRACT</title> <sec id="eat22274-sec-0001" sec-type="section"> <title>Objective</title> <p>To estimate direct and indirect costs of anorexia nervosa (AN), and to identify cost determinants.</p> </sec> <sec id="eat22274-sec-0002" sec-type="section"> <title>Methods</title> <p>In a subsample (<italic>n</italic> = 225) of the ANTOP trial (Anorexia Nervosa Treatment of OutPatients) health care utilization and productivity losses were assessed at baseline for the previous 3 months and monetarily valued. Included were females aged 18 years and older diagnosed with AN or subsyndromal AN, and a body mass index (BMI) between 15 and 18.5 kg/m<sup>2</sup>. To account for missing data multiple imputation was employed. Cost determinants were derived from generalized linear models with gamma distribution and log link function.</p> </sec> <sec id="eat22274-sec-0003" sec-type="section"> <title>Results</title> <p>Mean 3‐months costs per patient amounted to €5, 866 (SE = €576). The largest share of costs (€3, 374) resulted from hospitalizations. Determinants of direct costs were analyzed separately for those with hospitalizations for AN, and those without. In the group only treated as outpatients, participants with binge/purge subtype, and those diseased for more than 6 years had higher costs. Moreover, costs were increased in patients with a comorbid mental disorder. In the group with hospitalizations, direct costs increased with BMI. BMI was measured at the end of the observation period, indicating that longer duration of treatment yielded higher weight gain. Indirect costs were not significantly associated with any disease‐related characteristic.</p> </sec> <sec id="eat22274-sec-0004" sec-type="section"> <title>Discussion</title> <p>Costs resulting from health care utilization and productivity loss are substantial, although the sample studied had not received sufficient treatment. Future research should analyze the development of costs over time. © 2014 Wiley Periodicals, Inc. (Int J Eat Disord 2015; 48:139–146)</p> </sec> </abstract>