title: Excess comorbidity prevalence and cost associated with functional dyspepsia in an employed population.
abstract: BACKGROUND
  Limited published data exist on the associated comorbid conditions with functional dyspepsia (FD).
  
  
  OBJECTIVE
  This study aimed to assess the prevalence, services, and costs related to comorbid conditions associated with FD and the risk of having FD for each comorbid condition.
  
  
  METHODS
  A retrospective database analysis was undertaken using payroll data and adjudicated claims from January 1, 2001, through December 31, 2004 among >300,000 employees. Employees with FD were compared to propensity-score-matched employees without FD (controls). Outcome measures included the prevalence, costs, and utilization of health services for comorbid conditions as defined by the Agency for Healthcare Research and Quality (AHRQ) and the odds ratios of having FD from a multivariate model.
  
  
  RESULTS
  FD employees (N = 1,669) and a 50:1 matched control cohort (N = 83,450) were compared. Compared to matched controls, FD employees were more likely to have all major diagnostic categories. Moreover, 199/261 of the AHRQ's specific categories were more common in the FD cohort. Annual medical costs for the FD cohort were greater than for controls in 155/261 (59%) specific categories and significantly greater (P ≤ 0.05) in 76 categories (29%). Similarly, services were greater for 179/261 (69%) specific categories and significantly greater (P ≤ 0.05) in 110 categories (42%). In a multivariate model, esophageal disorders, gastritis and duodenitis, and abdominal pain were the most associated with having FD (odds ratios 3.8, 3.7, and 3.6, respectively). Only hypertension complications and disorders of the teeth and jaw were significantly negatively associated with FD.
  
  
  CONCLUSIONS
  There is unexplained excess comorbidity associated with FD which may be a major determining factor for excess healthcare services and costs.
authors.affiliation: The JeSTARx Group, 18 Hirth Drive , Newfoundland, NJ 07435-1710, USA. RBrook@JeSTARx.com
authors.forename: Richard A
authors.initials: RA
authors.lastname: Brook
authors.forename: Nathan L
authors.initials: NL
authors.lastname: Kleinman
authors.forename: Rok Seon
authors.initials: RS
authors.lastname: Choung
authors.forename: James E
authors.initials: JE
authors.lastname: Smeeding
authors.forename: Nicholas J
authors.initials: NJ
authors.lastname: Talley
mesh_terms: D000328:Adult; D016022:Case-Control Studies; D015331:Cohort Studies; D015897:Comorbidity; D004382:Duodenitis / Q000191:economics / Q000453:epidemiology*; D004415:Dyspepsia / Q000191:economics / Q000453:epidemiology*; D004935:Esophageal Diseases / Q000191:economics / Q000453:epidemiology*; D005260:Female; D005756:Gastritis / Q000191:economics / Q000453:epidemiology*; D017048:Health Care Costs; D006801:Humans; D016015:Logistic Models; D008297:Male; D015999:Multivariate Analysis; D016272:Occupational Health; D009786:Occupational Health Services / Q000191:economics*; D017063:Outcome Assessment, Health Care; D015995:Prevalence; D012189:Retrospective Studies; D014481:United States