title: Effect of aging on healthcare costs of inflammatory bowel disease: a glimpse into the future.
abstract: BACKGROUND
  Population aging is expected to result in a substantial additional burden on healthcare resources in the near future. We aimed to assess the current and future impact of aging on direct healthcare costs (DHC) attributed to inflammatory bowel disease (IBD).
  
  
  METHODS
  Patients with IBD from a Dutch multicenter cohort filled out 3-monthly questionnaires for 2 years. Elderly (≥60 yr) and younger patients (18-60 yr) IBD were analyzed for differences in 3-monthly DHC, productivity losses, and out-of-pocket costs. Prevalence rates were obtained from a health insurance database. Estimates of annual DHC and prevalence rates were applied to the total Dutch adult population in 2011 and then projected to 2040, using predicted changes in population demography, prices, and volume.
  
  
  RESULTS
  IBD-attributable DHC were lower in elderly than in younger patients with IBD with respect to 3-monthly DHC (&OV0556;359 versus &OV0556;978, P < 0.01), productivity losses (&OV0556;108 versus &OV0556;456, P < 0.01), and out-of-pocket costs (&OV0556;40 versus &OV0556;57, P < 0.01). Between 2011 and 2040, the percentage of elderly IBD patients in the Netherlands has been projected to rise from 24% to 35%. Between 2011 and 2040, DHC of the total IBD population in the Netherlands are projected to increase from &OV0556;161 to &OV0556;661 million. Population aging accounted for 1% of this increase, next to rising prices (29%), and volume growth (70%).
  
  
  CONCLUSIONS
  Population aging has a negligible effect on IBD-attributable DHC of the IBD population in the near future, because the average costs incurred by elderly patients with IBD are considerably lower than those incurred by younger patients with IBD.
authors: 1Department of Gastroenterology and Hepatology, University Medical Center Utrecht, Utrecht, the Netherlands 2Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht, the Netherlands; 3Agis Health Insurance, Amersfoort, the Netherlands; 4Department of Gastroenterology and Hepatology, VU University Medical Center, Amsterdam, the Netherlands; 5Department of Gastroenterology and Hepatology, University Medical Center Groningen, Groningen, the Netherlands; 6Department of Gastroenterology and Hepatology, Radboud University Nijmegen Medical Center, Nijmegen, the Netherlands; 7Department of Gastroenterology and Hepatology, Maastricht University Medical Center, Maastricht, the Netherlands; 8Department of Gastroenterology and Hepatology, Academic Medical Center, Amsterdam, the Netherlands; 9Department of Gastroenterology and Hepatology, Leiden University Medical Center, Leiden, the Netherlands; 10Department of Gastroenterology and Hepatology, Erasmus University Medical Center, Rotterdam, the Netherlands; 11Department of Gastroenterology and Hepatology, Slingeland Hospital, Doetinchem, the Netherlands; 12Department of Gastroenterology and Hepatology, Orbis Medical Center, Sittard, the Netherlands; 13Department of Gastroenterology and Hepatology, Diaconessenhuis, Leiden, the Netherlands; 14Department of Gastroenterology and Hepatology, Onze Lieve Vrouwe Gasthuis, Amsterdam, the Netherlands; 15Department of Gastroenterology and Hepatology, St. Antonius Hospital, Nieuwegein, the Netherlands; 16Department of Gastroenterology and Hepatology, Reinier de Graaf Groep, Delft, the Netherlands; and 17Department of Gastroenterology and Hepatology, Meander Medical Center, Amersfoort, the Netherlands.
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mesh_terms: D000293:Adolescent; D000328:Adult; D000367:Age Factors; D017281:Cost of Illness; D004526:Efficiency; D005260:Female; D005544:Forecasting; D017048:Health Care Costs / Q000639:trends*; D006296:Health Services / Q000191:economics / Q000706:statistics & numerical data*; D019456:Health Transition; D006801:Humans; D015212:Inflammatory Bowel Diseases / Q000191:economics* / Q000453:epidemiology* / Q000628:therapy; D008297:Male; D008875:Middle Aged; D009426:Netherlands / Q000453:epidemiology; D015995:Prevalence; D011795:Surveys and Questionnaires; D055815:Young Adult