title: All-cause health care charges among managed care patients with constipation and comorbid irritable bowel syndrome.
abstract: OBJECTIVE
  Chronic idiopathic constipation and irritable bowel syndrome (IBS) are common gastrointestinal conditions with potentially significant burden on managed care systems. Our objective was to examine all-cause resource utilization and charges associated with constipation alone (C-only) and with IBS with comorbid constipation (IBS+C).
  
  
  METHODS
  Administrative claims from a US health plan between January 1, 2003 and December 31, 2005 were analyzed. Patients with C-only (n = 48 585) and IBS+C (n = 10 952) were identified using International Classification of Diseases, 9th Revision, Clinical Modification diagnosis codes. Outcomes were compared with demographically matched controls and with a benchmark group of patients with migraine (N = 48 759). An index date was defined as the date 3 months prior to first observed diagnosis of the condition of interest. Outcomes were evaluated over a 12-month period before and after the index date.
  
  
  RESULTS
  The pre-to-post increase in total charges for subjects with C-only was substantially higher than that for the comparison group ($8837 vs $1717; P < 0.001) or the migraine group ($8837 vs $ 4804; P < 0.001). Subjects with IBS+C also had a greater pre-to-post increase in total charges than did comparison group members ($6192 vs $1319; P < 0.001) and subjects with migraine ($6192 vs $4804; P = 0.0120).
  
  
  CONCLUSIONS
  Both C-only and IBS+C impose substantial economic burden on third-party payers.
authors.affiliation: RTI Health Solutions, Research Triangle Park, NC, USA. mitra@rti.org
authors.forename: Debanjali
authors.initials: D
authors.lastname: Mitra
authors.forename: Keith L
authors.initials: KL
authors.lastname: Davis
authors.forename: Robert W
authors.initials: RW
authors.lastname: Baran
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D003248:Constipation / Q000191:economics*; D005260:Female; D005102:Health Expenditures / Q000706:statistics & numerical data*; D006296:Health Services / Q000706:statistics & numerical data*; D006801:Humans; D007345:Insurance Claim Review; D043183:Irritable Bowel Syndrome / Q000191:economics*; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D055815:Young Adult