This page contains a Flash digital edition of a book.
DIRECT COSTS


Previous research showed that individuals with IBD were twice as likely to have a hospitalization (15% per year), compared to people without IBD (7% per year).70


People with


CD were more likely to have a hospitalization than people with UC. A considerable amount of hospitalization occurs within the first years of diagnosis of disease.72


For those people who will


have an IBD hospitalization, 58% of these hospitalizations occur within the first two years of diagnosis, and 36% of surgeries also occur within the first two years. Similar patterns are found in the United States.73


Historically, hospitalizations and surgeries were inevitable for most people with IBD. A Canadian survey was conducted in people with IBD who had a mean duration of disease of 18 years for CD and 15 years for UC. Amongst those with CD, 84% had been hospitalized and 65% had received surgery. For people with UC, 51% had been hospitalized, and 16% had ever received surgery.55


The inevitability of surgery may be changing. There have been interesting trends in the patterns of hospitalization and surgery over time for people with CD, which have been observed and reported around the world. Surgical rates have been falling, and since half of all CD hospitalizations involve surgery, the rate of hospitalization has fallen as well.74


People


diagnosed with CD since 2001 were much more likely to see a gastroenterologist within the first year of diagnosis, and have a reduced use of surgery and associated hospitalizations.75 They also had higher use of immunomodulators and biologics. Specialist care from the outset of the disease is associated with these trends to reduced surgery and more aggressive use of medication to manage disease. These changes affect not only the type and total cost of care for people with IBD, but also change lives and health outcomes. (Note that the Manitoba study that was used to estimate direct medical costs, relied on health care records from the most recent time period, and therefore the estimated direct medical costs reflect current trends).


Children with IBD have been observed to have greater use of pediatric gastroenterologists (versus adult gastroenterologists) in recent years, which may contribute to improvements in overall care and better outcomes in this age group. Since the 1990s, there has been a stable rate of age-adjusted hospitalization amongst children with IBD, but there has been a 30% decrease in the need for surgery in children with CD (no change in the surgical rate for children with UC). Finally, children are more likely to receive immunomodulatory and biological therapy than previously.76


key findings:


• Excess hospitalizations related to IBD cost $395 million per year for people with IBD. • The annual per-person cost is $2,521 for IBD related inpatient and out-patient hospitalizations and physician visits.


• Most patients experience their first hospitalization within two years of diagnosis.


THE IMPACT OF INFLAMMATORY BOWEL DISEASE IN CANADA 50


Page 1  |  Page 2  |  Page 3  |  Page 4  |  Page 5  |  Page 6  |  Page 7  |  Page 8  |  Page 9  |  Page 10  |  Page 11  |  Page 12  |  Page 13  |  Page 14  |  Page 15  |  Page 16  |  Page 17  |  Page 18  |  Page 19  |  Page 20  |  Page 21  |  Page 22  |  Page 23  |  Page 24  |  Page 25  |  Page 26  |  Page 27  |  Page 28  |  Page 29  |  Page 30  |  Page 31  |  Page 32  |  Page 33  |  Page 34  |  Page 35  |  Page 36  |  Page 37  |  Page 38  |  Page 39  |  Page 40  |  Page 41  |  Page 42  |  Page 43  |  Page 44  |  Page 45  |  Page 46  |  Page 47  |  Page 48  |  Page 49  |  Page 50  |  Page 51  |  Page 52  |  Page 53  |  Page 54  |  Page 55  |  Page 56  |  Page 57  |  Page 58  |  Page 59  |  Page 60  |  Page 61  |  Page 62  |  Page 63  |  Page 64  |  Page 65  |  Page 66  |  Page 67  |  Page 68  |  Page 69  |  Page 70  |  Page 71  |  Page 72  |  Page 73  |  Page 74  |  Page 75  |  Page 76  |  Page 77  |  Page 78  |  Page 79  |  Page 80  |  Page 81  |  Page 82  |  Page 83  |  Page 84  |  Page 85  |  Page 86  |  Page 87  |  Page 88  |  Page 89  |  Page 90  |  Page 91  |  Page 92  |  Page 93  |  Page 94  |  Page 95  |  Page 96