title: Healthcare costs and resource utilization of patients with binge-eating disorder and eating disorder not otherwise specified in the Department of Veterans Affairs.
abstract: OBJECTIVE
  The objective of this study was to compare the one-year healthcare costs and utilization of patients with binge-eating disorder (BED) to patients with eating disorder not otherwise specified without BED (EDNOS-only) and to matched patients without an eating disorder (NED).
  
  
  METHODS
  A natural language processing (NLP) algorithm identified adults with BED from clinical notes in the Department of Veterans Affairs (VA) electronic health record database from 2000 to 2011. Patients with EDNOS-only were identified using ICD-9 code (307.50) and those with NLP-identified BED were excluded. First diagnosis date defined the index date for both groups. Patients with NED were randomly matched 4:1, as available, to patients with BED on age, sex, BMI, depression diagnosis, and index month. Patients with cost data (2005-2011) were included. Total healthcare, inpatient, outpatient, and pharmacy costs were examined. Generalized linear models were used to compare total one-year healthcare costs while adjusting for baseline patient characteristics.
  
  
  RESULTS
  There were 257 BED, 743 EDNOS-only, and 823 matched NED patients identified. The mean (SD) total unadjusted one-year costs, in 2011 US dollars, were $33,716 ($38,928) for BED, $37,052 ($40,719) for EDNOS-only, and $19,548 ($35,780) for NED patients. When adjusting for patient characteristics, BED patients had one-year total healthcare costs $5,589 higher than EDNOS-only (p = 0.06) and $18,152 higher than matched NED patients (p < 0.001).
  
  
  CONCLUSIONS
  This study is the first to use NLP to identify BED patients and quantify their healthcare costs and utilization. Patients with BED had similar one-year total healthcare costs to EDNOS-only patients, but significantly higher costs than patients with NED.
authors.affiliation: VA Salt Lake City Health Care System, Salt Lake City, Utah.|Department of Pharmacotherapy, University of Utah College of Pharmacy, Salt Lake City, Utah.
authors.forename: Brandon K
authors.initials: BK
authors.lastname: Bellows
authors.affiliation: VA Salt Lake City Health Care System, Salt Lake City, Utah.|Department of Pharmacotherapy, University of Utah College of Pharmacy, Salt Lake City, Utah.|Division of Epidemiology, University of Utah School of Medicine, Salt Lake City, Utah.
authors.forename: Scott L
authors.initials: SL
authors.lastname: DuVall
authors.affiliation: Anolinx LLC, Salt Lake City, Utah.
authors.forename: Aaron W C
authors.initials: AW
authors.lastname: Kamauu
authors.affiliation: Shire Development Inc, Wayne, Pennsylvania.
authors.forename: Dylan
authors.initials: D
authors.lastname: Supina
authors.affiliation: Shire Development Inc, Wayne, Pennsylvania.
authors.forename: Thomas
authors.initials: T
authors.lastname: Babcock
authors.affiliation: VA Salt Lake City Health Care System, Salt Lake City, Utah.|Department of Pharmacotherapy, University of Utah College of Pharmacy, Salt Lake City, Utah.
authors.forename: Joanne
authors.initials: J
authors.lastname: LaFleur
mesh_terms: D000328:Adult; D056912:Binge-Eating Disorder / Q000191:economics*; D015331:Cohort Studies; D057286:Electronic Health Records; D001068:Feeding and Eating Disorders / Q000191:economics*; D005260:Female; D017048:Health Care Costs; D006801:Humans; D008297:Male; D008875:Middle Aged; D010342:Patient Acceptance of Health Care / Q000706:statistics & numerical data*; D014481:United States; D014493:United States Department of Veterans Affairs / Q000706:statistics & numerical data*; D014728:Veterans / Q000706:statistics & numerical data
keywords: binge-eating disorder; eating disorder not otherwise specified; healthcare costs; healthcare utilization; observational study