| Title: |
Effect of phenotype on health care costs in Crohn's disease: A European study using the Montreal classification |
| Authors: |
Odes, Selwyn; Vardi, Hillel; Friger, Michael; Wolters, Frank; Hoie, Ole; Moum, Bjørn; Bernklev, Tomm; Yona, Hagit; Russel, Maurice; Munkholm, Pia; Langholz, Ebbe; Riis, Lene; Politi, Patrizia; Bondini, Paolo; Tsianos, Epameinondas; Katsanos, Kostas; Clofent, Juan; Vermeire, Severine; Freitas, João; Mouzas, Iannis; Limonard, Charles; O'Morain, Colm; Monteiro, Estela; Fornaciari, Giovanni; Vatn, Morten; Stockbrugger, Reinhold; on behalf of the European Collaborative Study Group on Inflammatory Bowel Disease |
| Publisher Information: |
Oxford University Press |
| Publication Year: |
2007 |
| Collection: |
HighWire Press (Stanford University) |
| Subject Terms: |
Regular Papers |
| Description: |
Background: Crohn's disease (CD) is a chronic inflammation of the gastrointestinal tract associated with life-long high health care costs. We aimed to determine the effect of disease phenotype on cost. Methods: Clinical and economic data of a community-based CD cohort with 10-year follow-up were analyzed retrospectively in relation to Montreal classification phenotypes. Results: In 418 patients, mean total costs of health care for the behavior phenotypes were: nonstricturing–nonpenetrating 1690, stricturing 2081, penetrating 3133 and penetrating-with-perianal-fistula 3356 €/patient-phenotype-year ( P < 0.001), and mean costs of surgical hospitalization 215, 751, 1293 and 1275 €/patient-phenotype-year respectively ( P < 0.001). Penetrating-with-perianal-fistula patients incurred significantly greater expenses than penetrating patients for total care, diagnosis and drugs, but not surgical hospitalization. Total costs were similar in the location phenotypes: ileum 1893, colon 1748, ileo-colonic 2010 and upper gastrointestinal tract 1758 €/patient-phenotype-year, but surgical hospitalization costs differed significantly, 558, 209, 492 and 542 €/patient-phenotype-year respectively ( P < 0.001). By multivariate analysis, the behavior phenotype significantly impacted total, medical and surgical hospitalization costs, whereas the location phenotype affected only surgical costs. Younger age at diagnosis predicted greater surgical expenses. Conclusions: Behavior is the dominant phenotype driving health care cost. Use of the Montreal classification permits detection of cost differences caused by perianal fistula. |
| Document Type: |
text |
| File Description: |
text/html |
| Language: |
English |
| Relation: |
http://ecco-jcc.oxfordjournals.org/cgi/content/short/1/2/87; http://dx.doi.org/10.1016/j.crohns.2007.08.004 |
| DOI: |
10.1016/j.crohns.2007.08.004 |
| Availability: |
http://ecco-jcc.oxfordjournals.org/cgi/content/short/1/2/87; https://doi.org/10.1016/j.crohns.2007.08.004 |
| Rights: |
Copyright (C) 2007, Oxford University Press |
| Accession Number: |
edsbas.95E2AE06 |
| Database: |
BASE |