title: Higher levels of knowledge reduce health care costs in patients with inflammatory bowel disease.
abstract: BACKGROUND
  The potentially high costs of care associated with inflammatory bowel disease are recognized. A knowledge-based self-management approach seems to reduce health care costs, improve disease control, and reduce indirect costs. The aim of this study was to determine whether there is a significant association between patient knowledge and health care costs.
  
  
  METHODS
  Patients diagnosed with inflammatory bowel disease, Crohn's disease (CD), ulcerative colitis, or indeterminate colitis, in 2010 to 2011 were included. Direct costs were investigated for each patient, including costs of blood tests, procedures, medications, hospitalization, and visits. Specific prices were reported according to the hospital billing database for 2010. For medical and surgical hospital admissions, DRG 19 prices were reported. A validated questionnaire (CCKNOW) was used to assess disease-related knowledge.
  
  
  RESULTS
  Ninety-one patients (38 men), mean age 47 years (range, 33-63 yr) were studied (14 indeterminate colitis, 33 CD, and 44 ulcerative colitis). Median cost for patients is higher in CD (&OV0556;4099.02). The mean overall CCKNOW score was 8.00 (8.50 for indeterminate colitis, 7.50 for CD, and 7.50 for ulcerative colitis). An increase of 5 points on the CCKNOW corresponds to a cost decrease of &OV0556;1099.53 in the first year of disease.
  
  
  CONCLUSIONS
  Higher levels of knowledge were shown to be associated with significantly lower health care costs. The data suggest that better information could lead to better choices and improved outcomes; thus, patient information and education is a key priority for managing patients with inflammatory bowel disease, perhaps planning structured and formal patient education programs in the future.
authors: *Gastroenterology Unit and †Clinical Research Unit, Padova University Hospital, Padova, Italy; and ‡Unit of Biostatistics, Epidemiology and Public Health, Department of Cardiac, Thoracic and Vascular Sciences, University of Padova, Padova, Italy.
authors: Federica
authors: F
authors: Colombara
authors: Matteo
authors: M
authors: Martinato
authors: Giulia
authors: G
authors: Girardin
authors: Dario
authors: D
authors: Gregori
mesh_terms: D000293:Adolescent; D000328:Adult; D002648:Child; D002675:Child, Preschool; D003695:Delivery of Health Care / Q000706:statistics & numerical data*; D005260:Female; D017048:Health Care Costs / Q000706:statistics & numerical data*; D007722:Health Knowledge, Attitudes, Practice; D006760:Hospitalization / Q000706:statistics & numerical data; D006801:Humans; D015212:Inflammatory Bowel Diseases / Q000191:economics* / Q000517:prevention & control*; D008297:Male; D008875:Middle Aged; D010353:Patient Education as Topic; D011379:Prognosis; D012189:Retrospective Studies; D012648:Self Care; D011795:Surveys and Questionnaires; D055815:Young Adult