title: Economic burden of irritable bowel syndrome in China.
abstract: OBJECTIVE
  To estimate annual direct and indirect costs for patients diagnosed with irritable bowel syndrome (IBS) and subtypes.
  
  
  METHODS
  Patients completed a standardized questionnaire concerning usage of healthcare resources, travel costs, meals, and productivity loss of patients when seeking treatment for IBS. Total annual costs per patient were calculated as the sum of direct (including medical and nonmedical) and indirect costs. Total annual costs per patient among various IBS subtypes were compared. Analysis of variance and bootstrapped independent samplet-tests were performed to determine differences between groups after controlling for IBS subtypes.
  
  
  RESULTS
  A total of 105 IBS patients (64.80% female), mean age of 57.12 years ± 10.31 years), mean disease duration of 4.31 years ± 5.40 years, were included. Total annual costs per patient were estimated as CNY18262.84 (USD2933.08). Inpatient and outpatient healthcare use were major cost drivers, accounting for 46.41%and 23.36% of total annual costs, respectively. Productivity loss accounted for 25.32% of total annual costs. The proportions of direct and indirect costs were similar to published studies in other countries. Nationally, the total costs of managing IBS would amount to CNY123.83 billion (USD1.99 billion). Among the IBS subtypes, total annual costs per patient of IBS-M was highest at CNY18891.18 (USD3034). Furthermore, there was significant difference in productivity loss among IBS subtypes (P= 0.031).
  
  
  CONCLUSIONS
  IBS imposes a huge economic burden on patients and healthcare systems, which could account for 3.3% of the total healthcare budget for the entire Chinese nation. More than two-thirds of total annual costs of IBS consist of inpatient and outpatient healthcare use. Among the subtypes, IBS-M patients appear to have the greatest economic burden but require further confirmation.
authors.affiliation: Fang Zhang, Wei Xiang, College of Business Administration, Shenyang Pharmaceutical University, Shenyang 110016, Liaoning Province, China.
authors.forename: Fang
authors.initials: F
authors.lastname: Zhang
authors.affiliation: Fang Zhang, Wei Xiang, College of Business Administration, Shenyang Pharmaceutical University, Shenyang 110016, Liaoning Province, China.
authors.forename: Wei
authors.initials: W
authors.lastname: Xiang
authors.affiliation: Fang Zhang, Wei Xiang, College of Business Administration, Shenyang Pharmaceutical University, Shenyang 110016, Liaoning Province, China.
authors.forename: Chun-Yan
authors.initials: CY
authors.lastname: Li
authors.affiliation: Fang Zhang, Wei Xiang, College of Business Administration, Shenyang Pharmaceutical University, Shenyang 110016, Liaoning Province, China.
authors.forename: Shu-Chuen
authors.initials: SC
authors.lastname: Li
mesh_terms: D000041:Absenteeism; D000368:Aged; D000553:Ambulatory Care / Q000191:economics; D002681:China / Q000453:epidemiology; D017281:Cost of Illness; D004526:Efficiency; D005260:Female; D017048:Health Care Costs; D005102:Health Expenditures; D006295:Health Resources / Q000191:economics* / Q000706:statistics & numerical data; D017721:Hospital Costs; D006801:Humans; D043183:Irritable Bowel Syndrome / Q000175:diagnosis / Q000191:economics* / Q000453:epidemiology / Q000628:therapy*; D008297:Male; D062407:Meals; D008875:Middle Aged; D011446:Prospective Studies; D018582:Sick Leave / Q000191:economics; D013997:Time Factors; D014186:Transportation / Q000191:economics
keywords: Burden of illness; Direct and indirect medical and nonmedical costs; Irritable bowel syndrome; Irritable bowel syndrome subtype; Productivity loss