title: The burden of inflammatory bowel disease on health care utilization and quality of life.
abstract: OBJECTIVE
  The aim of this study was to explore the utilization of health services by Finnish adults with inflammatory bowel disease (IBD) and to assess the associated demographic and health-related quality of life (HRQoL) factors.
  
  
  METHODS
  556 Finnish IBD patients eligible for reimbursement for IBD medication according to the Social Insurance Institution in Finland answered our postal cross-sectional survey. The study questionnaire included questions about demographic characteristics of the patients, health care resource use, and HRQoL. The number of doctor visits was compared with those of irritable bowel syndrome patients.
  
  
  RESULTS
  During the previous year, more than three quarters of the respondents reported disturbing IBD symptoms. The majority (64%) had seen a doctor due to their IBD, women more often than men (p < 0.001). The use of health services did not differ between diagnostic (Crohn's disease or ulcerative colitis) or age groups, marital status, education, or time elapsed since diagnosis. Women were absent from work more frequently than men (p = 0.01). The amount of physician visits, work absenteeism, and a higher amount of undergone procedures were related to impaired HRQoL (p < 0.001 on all accounts).
  
  
  CONCLUSIONS
  Despite comprehensive public health services and specialized care for IBD patients in Finland, a majority expressed disturbing IBD symptoms. Since the amount of physician visits, work absenteeism and a higher amount of procedures were related to a diminished HRQoL, the patients who are most often met by professional caregivers are often those whose HRQoL needs to be more adequately addressed.
authors.affiliation: School of Health Sciences, Nursing Science, University of Tampere, Tampere, Finland.
authors.forename: Ellinoora
authors.initials: E
authors.lastname: Nurmi
authors.forename: Johanna
authors.initials: J
authors.lastname: Haapamäki
authors.forename: Eija
authors.initials: E
authors.lastname: Paavilainen
authors.forename: Anja
authors.initials: A
authors.lastname: Rantanen
authors.forename: Markku
authors.initials: M
authors.lastname: Hillilä
authors.forename: Perttu
authors.initials: P
authors.lastname: Arkkila
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D017281:Cost of Illness; D003430:Cross-Sectional Studies; D005260:Female; D005387:Finland; D006296:Health Services / Q000706:statistics & numerical data*; D006304:Health Status; D006801:Humans; D015212:Inflammatory Bowel Diseases / Q000150:complications / Q000523:psychology / Q000628:therapy*; D043183:Irritable Bowel Syndrome / Q000150:complications / Q000523:psychology / Q000628:therapy; D008297:Male; D008875:Middle Aged; D009819:Office Visits / Q000706:statistics & numerical data; D011788:Quality of Life; D012737:Sex Factors; D012959:Socioeconomic Factors; D055815:Young Adult