title: A case-control comparison of direct healthcare-provider medical costs of chronic idiopathic constipation and irritable bowel syndrome with constipation in a community-based cohort.
abstract: OBJECTIVE
  Patients with constipation account for 3.1 million US physician visits a year, but care costs for patients with irritable bowel syndrome with constipation (IBS-C) or chronic idiopathic constipation (CIC) compared to the general public have received little study. The study aim was to describe healthcare utilization and compare medical costs for patients with IBS-C or CIC vs matched controls from a community-based sample.
  
  
  METHODS
  A nested case-control sample (IBS-C and CIC cases) and matched controls (1:2) for each case group were selected from Olmsted County, MN, individuals responding to a community-based survey of gastrointestinal symptoms (2008) who received healthcare from a participating Rochester Epidemiology Project (REP) provider. Using REP healthcare utilization data, unadjusted and adjusted standardized costs were compared for the 2- and 10-year periods prior to the survey for 115 IBS-C patients and 230 controls and 365 CIC patients and 730 controls. Two time periods were chosen as these conditions are episodic, but long-term.
  
  
  RESULTS
  Outpatient costs for IBS-C ($6,800) and CIC ($6,284) patients over a 2-year period prior to the survey were significantly higher than controls ($4,242 and $5,254, respectively) after adjusting for co-morbidities, age, and sex. IBS-C outpatient costs ($25,448) and emergency room costs ($6,892) were significantly higher than controls ($21,024 and $3,962, respectively) for the 10-year period prior. Unadjusted data analyses of cases compared to controls demonstrated significantly higher imaging costs for IBS-C cases and procedure costs for CIC cases over the 10-year period.
  
  
  CONCLUSIONS
  Data were collected from a random community sample primarily receiving care from a limited number of providers in that area.
  
  
  CONCLUSIONS
  Patients with IBS-C and CIC had significantly higher outpatient costs for the 2-year period compared with controls. IBS-C patients also had higher ER costs than the general population.
authors: a Gastroenterology and Hepatology , Mayo Clinic , Rochester , MN , USA.|b South Dakota State University , Brookings , SD , USA.
authors: Linda M
authors: LM
authors: Herrick
authors: c Ironwood Pharmaceuticals , Cambridge , MA , USA.
authors: William M
authors: WM
authors: Spalding
authors: a Gastroenterology and Hepatology , Mayo Clinic , Rochester , MN , USA.
authors: Yuri A
authors: YA
authors: Saito
authors: d Center for the Science of Health Care Delivery, Mayo Clinic , Rochester , MN , USA.
authors: James
authors: J
authors: Moriarty
authors: e Biomedical Statistics and Informatics , Mayo Clinic , Rochester , MN , USA.
authors: Cathy
authors: C
authors: Schleck
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D016022:Case-Control Studies; D002908:Chronic Disease / Q000191:economics*; D015331:Cohort Studies; D015897:Comorbidity; D003248:Constipation / Q000191:economics*; D005260:Female; D017048:Health Care Costs; D006801:Humans; D043183:Irritable Bowel Syndrome / Q000191:economics*; D008297:Male
keywords: Costs; Irritable bowel syndrome with constipation; chronic idiopathic constipation; economic burden; healthcare resource utilization