Utilization patterns and net direct medical cost to Medicaid of irritable bowel syndrome

SUMMARY

Background: Patients with irritable bowel syndrome are frequent users of the health care system.

Design and methods: This retrospective matched case-control study assessed the economic impact of irritable bowel syndrome on the Medicaid program by comparing the health care utilization and expenditures of Medicaid patients with irritable bowel syndrome in California and North Carolina with age-, sex-, and race-matched control groups without the syndrome.

Results: Average annual Medicaid expenditures per case of diagnosed irritable bowel syndrome

were $2952 and $5908 in California and North Carolina, respectively; corresponding unadjusted net incremental expenditures were $962 and $2191, respectively. In both states, patients with irritable bowel syndrome incurred greater costs than controls for physician visits, outpatient visits, and prescription drugs.

Conclusions: Irritable bowel syndrome was shown to impose an economic burden on the Medicaid program. The cost of treating patients with irritable bowel syndrome is higher than the cost of treating matched ambulatory Medicaid recipients without the condition.

Key words: :

• Cost of illness
• unctional colonic diseases
• ealth care costs
• Medicaid
• isk adjustment
• tilization review

Notes

* This study was presented, in part, at the following two conferences: 2002 Digestive Disease Weekly (DDW) Conference, San Francisco, CA, May 22, 2002; and 2001 American College of Gastroenterology Annual Meeting, Las Vegas, NV, October 23, 2001