title: Longitudinal direct medical costs associated with constipation in women.
abstract: BACKGROUND
  Although direct medical costs for constipation-related medical visits are thought to be high, to date, there have been no studies examining longitudinal resource utilisation in adults with constipation.
  
  
  OBJECTIVE
  To estimate the incremental direct medical costs associated with constipation in women.
  
  
  METHODS
  This is a nested case-control study. The study population consisted of all mothers of 5718 children in the population-based birth cohort born during 1976-1982 in a community. The cases presented to the medical facilities with constipation. The controls were randomly selected and matched to cases in a 2:1 ratio. Direct medical costs for constipated women and controls were collected for the years 1987-2002.
  
  
  RESULTS
  We identified 168 women with a diagnosis of constipation. The total direct medical costs over the 15-year period for constipated subjects were more than double those of controls [$63 591 (95% CI: 49 786-81 396) vs. $24 529 (95% CI: 20 667-29 260)]. The overall out-patient costs for constipated women were $38 897 (95% CI: 31 381-48 253) compared to $15 110 (95% CI: 12 904-17 781) for controls. The median of annual out-patient visits for constipated women was 0.16 compared to 0.11 for controls.
  
  
  CONCLUSIONS
  Women with constipation have significantly higher medical care utilisation and expenditures compared with women without constipation.
authors.affiliation: Division of Gastroenterology and Hepatology, Department of Medicine, Mayo Clinic, Rochester, MN, USA. Department of Health Sciences Research, Mayo Clinic, Rochester, MN, USA. University of North Carolina Center for Functional GI and Motility Disorders, Chapel Hill, NC, USA. Department of Medicine, Mayo Clinic, Jacksonville, FL, USA.
authors.forename: R S
authors.initials: RS
authors.lastname: Choung
authors.forename: M E
authors.initials: ME
authors.lastname: Branda
authors.forename: D
authors.initials: D
authors.lastname: Chitkara
authors.forename: N D
authors.initials: ND
authors.lastname: Shah
authors.forename: S K
authors.initials: SK
authors.lastname: Katusic
authors.forename: G R
authors.initials: GR
authors.lastname: Locke
authors.forename: N J
authors.initials: NJ
authors.lastname: Talley
mesh_terms: D000328:Adult; D016022:Case-Control Studies; D003248:Constipation / Q000191:economics* / Q000453:epidemiology / Q000628:therapy; D005260:Female; D005500:Follow-Up Studies; D017048:Health Care Costs / Q000706:statistics & numerical data*; D006801:Humans; D008137:Longitudinal Studies; D008910:Minnesota / Q000453:epidemiology; D012959:Socioeconomic Factors