P443 Systematic analysis of annual health resource utilisation and costs in hospitalised inflammatory bowel disease patients in Switzerland. (16th January 2018)

• Record Type: Journal Article
• Authors: Schoepfer, A; Vavricka, S; Bruengger, B; Reich, O; Blozik, E; Bähler, C
• Is Part Of: Journal of Crohn's and colitis. Volume 12:Number 1(2018:Jan.)Supplement 1
• Page Start: S328
• Page End: S329
• Publication Date: 2018-01-16
• Subjects: Inflammatory bowel diseases -- Periodicals; 616.344005
• DOI: 10.1093/ecco-jcc/jjx180.570
• Languages: English
• ISSNs: 1873-9946

Abstract

Abstract: Background: Up-to-date real-life data on health resource utilisation and costs of hospitalised patients with inflammatory bowel disease (IBD) are rare. We aimed to assess health resource utilisation and costs among IBD patients in Switzerland during a 1-year follow-up period starting with an index hospitalisation. Methods: Based on claims data of the Helsana health insurance group, health resource utilisation was assessed and costs reimbursed by mandatory basic health insurance (in euros) were calculated during a 1-year follow-up period starting with an index hospitalisation in the time period between January 1, 2013, to December 31, 2014. Helsana is a large health insurance that covers about 1.2 millions of police holders in Switzerland which corresponds to 15% of the entire Swiss population that consists of 8 million inhabitants. Results: Of 202, 002 patients with at least one hospitalisation in 2013–2014, a total of 270 patients (0.13%) had IBD as main diagnosis (112 UC [41.5%], 158 CD [58.5%], females 154 of 270 [57.0%]). In comparison with UC patients, CD patients were significantly more frequently treated with biologics (45.6% vs. 20.5%, p < 0.001) and more frequently underwent surgery during index hospitalisation (27.8% vs. 9.8%, p = 0.002). Compared with UC patients, CD patients had significantly more frequently a re-hospitalisation (OR 1.53, 95% CI 1.09–2.16, p = 0.014), consultations (OR 1.06, 95% CI 1.01–1.12, p = 0.016), higher median annual costs (OR 1.25, 95% CI 1.05–1.48, p = 0.012), and outpatient costs (OR 1.33, 95% CI 1.07–1.66, p = 0.011). In the bivariate model, median total costs for CD and UC patients was 20, 772 and 14, 781 euros, respectively ( p = 0.032). Outpatient costs accounted for roughly two-thirds of total costs (median 9, 979 euros) while inpatient costs accounted for one-third of total costs (median 4, 981 euros). Major outpatient cost drivers in IBD patients were drugs (median 3, 466 euros), specialist consultations (median 2, 388 euros), laboratory costs (median 745 euros), and family physician consultations (median 488 euros). Conclusions: When compared with UC patients, hospitalised CD patients have during a 1-year follow-up a higher rate of re-hospitalisation, outpatient consultations, and generate higher costs. IBD drugs represent the main cost driver in outpatient costs.