Prospective Study
Copyright
©The Author(s) 2016. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Gastroenterol. Dec 21, 2016; 22(47): 10450-10460
Published online Dec 21, 2016. doi: 10.3748/wjg.v22.i47.10450
Table 1 Characteristics of four irritable bowel syndrome-subtypes n (%)
Characteristics IBS (n = 105) IBS-C (n = 23) IBS-D (n = 42) IBS-M (n =9) IBS-U (n = 31) P valueAge (yr) (mean ± SD) 57.1 ± 10.3 60.3 ± 8.7 54.9 ± 11.9 52.0 ± 9.6 59.3 ± 8.2 0.0491 ≤ 50 24 (22.9) 2 (8.7) 12 (28.6) 5 (55.6) 5 (16.1) 51-60 39 (37.1) 11 (47.8) 14 (33.3) 1 (11.1) 13 (41.9) 61-70 35 (33.3) 8 (34.8) 13 (31.0) 3 (33.3) 11 (35.5) ≥ 71 7 (6.7) 2 (8.7) 3 (7.1) 0 (0.0) 2 (6.5) Disease duration (yr) (mean ± SD) 4.3 ± 5.4 3.0 ± 2.7 5.0 ± 5.7 6.8 ± 10.6 3.8 ± 4.3 0.247 < 1 33 (31.4) 8 (34.8) 11 (26.2) 3 (33.3) 11 (35.5) 1-3 33 (31.4) 9 (39.2) 13 (31.0) 4 (44.4) 9 (29.0) 3-5 19 (18.2) 3 (13.0) 8 (19.0) 0 (0.0) 6 (19.4) > 5 20 (19.0) 3 (13.0) 10 (23.8) 2 (22.3) 5 (16.1) Gender < 0.0012 Male 37 (35.2) 6 (26.1) 24 (57.1) 4 (44.4) 3 (9.7) Female 68 (64.8) 17 (73.9) 18 (42.8) 5 (55.6) 28 (90.3) Employment Status 0.094 Retired 42 (40.0) 10 (43.5) 16 (38.1) 3 (33.3) 13 (41.9) Employed 63 (60.0) 13 (56.5) 26 (61.9) 6 (66.7) 8 (58.1) Income level 0.096 Lower income 43 (40.9) 10 (43.5) 15 (35.7) 5 (55.6) 13 (41.9) Middle income 55 (52.4) 12 (52.2) 25 (59.5) 2 (22.2) 16 (51.6) Higher income 7 (6.7) 1 (4.3) 2 (4.8) 2 (22.2) 2 (6.5)
Table 2 Direct medical costs (CNY yuan)
Direct medical costs No. of patients Average visits per 4 wk Average visits per year 4-wk drug cost per patient 4-wk medical cost per patient Annual costs per patient Outpatient 99 (94.29%) 1.01 12.42 213.57 (185.86-246.95) 112.49 (82.04-142.77) 4266.58 (3705.55-4838.44) Pharmacy 13 (12.38%) 1.08 1.72 17.33 (7.53-28.29) 0.76 (0.34-1.25) 31.56 (13.74- 51.29) Inpatient 105 (100%) 0.01 1.28 290.76 (261.82-320.29) 359.03 (340.65-377.07) 8476.30 (7888.07-9050.18) Total costs 521.67 (76.32-91.09) 472.28 (437.26-507.22) 12761.14 (11885.82-13595.74)
Table 3 Direct nonmedical costs (CNY yuan)
Direct nonmedical costs No. of patients 4-wk costs per patient Annual costs per patient Travel 105 (100%) 23.06 (19.65-26.57) 749.75 (645.57-867.93) Meals 98 (93.33%) 6.49 (4.77-8.30) 79.03 (58.16-101.00) Health food 8 (7.62%) 49.05 (14.28-97.13) 48.75 (14.20-96.55) Total costs 78.60 (42.55-127.91) 877.54 (752.62-1022.94)
Table 4 Indirect costs (CNY yuan)
Indirect costs 4-wk lost work days Average costs per 4 wk Annual lost work days per patient Annual costs per patient Outpatient 0.62 (0.57-0.68) 108.71 (99.60-117.84) 8.14 (7.45-8.88) 1337.07 (1225.06-1449.34) Pharmacy 0.06 (0.03-0.10) 10.79 (4.98-17.43) 0.81 (0.37-1.30) 17.42 (8.04-28.15) Inpatient 1.10 (1.04-1.16) 190.85 (180.80-202.17) 14.29 (13.54-15.13) 2489.59 (2358.47-1637.26) Resting at home 0.34 (0.32-0.36) 59.80 (56.87-62.98) 4.48 (4.25-4.71) 780.07 (741.90-821.56) Total costs 2.13 (2.04-2.22) 370.15 (355.61-386.23) 27.71 (26.62-28.91) 4624.15 (4456.32-4802.13)
Table 5 Total costs (CNY yuan)
4-wk costs per patient Annual costs per patient Direct medical costs 993.95 (934.37-1059.57) 12761.14 (11885.82-13595.74) Outpatient 326.06 (285.86-372.84) 4266.58 (3705.55-4838.44) Pharmacy 18.10 (7.77-28.25) 31.56 (13.74- 51.29) Inpatient 649.79 (601.91-693.69) 8476.30 (7888.07-9050.18) Direct nonmedical costs 78.60 (42.55-127.91) 877.54 (752.62-1022.94) Travel 23.06 (19.65-26.57) 749.75 (645.57-867.93) Meals 6.49 (4.77-8.30) 79.03 (58.16-101.00) Health food 49.05 (14.28-97.13) 48.75 (14.20-96.55) Indirect costs 370.15 (355.61-386.23) 4624.15 (4456.32-4802.13) Outpatient 108.71 (99.60-117.84) 1337.07 (1225.06-1449.34) Pharmacy 10.79 (4.98-17.43) 17.42 (8.04-28.15) Inpatient 190.85 (180.80-202.17) 2489.59 (2358.47-1637.26) Resting at home 59.80 (56.87-62.98) 780.07 (741.90-821.56) Total costs 1442.70 (1356.99-1520.09) 18262.84 (17326.86-19158.27)
Table 6 Total costs for the entire Chinese population
Total costs National health budget Costs as % of national health budget GDP Total costs as % of GDP Units National Per capita National Per capita National Per capita 123.83 B (1.99 B) 18262.84 (2933.08) 3758.48 B (603.63 B) 3.29% 67670.8 B (10868.2 B) 51560.3 (8280.8) 0.18% 35% 2015CNY (2015USD)
Table 7 Total costs of four irritable bowel syndrome subtypes (CNY yuan)
IBS-C IBS-D IBS-M IBS-U P valueDirect medical costs 12036.72 (10319.41-13841.58) 12838.55 (11570.90-14221.77) 12990.03 (11094.74-14757.98) 13127.30 (11484.21-14680.82) 0.830 Direct nonmedical costs 973.31 (741.98-1252.00) 812.15 (586.09-1114.49) 986.80 (95.42-201.77) 863.34 (716.92-1025.52) 0.792 Indirect costs 4449.10 (4020.92-4893.99) 4890.66 (4648.80-5169.87) 4914.35 (4446.81-5340.35) 4308.71 (4017.27-4584.88) 0.0311 Total costs 17459.12 (15369.32-19486.61) 18541.36 (17241.44-19933.29) 18891.18 (16960.86-20813.44) 18299.35 (16423.33-20269.52) 0.817
Table 8 Economic burden per person with irritable bowel syndrome in other studies
Ref .Country Total costs Units Direct Indirect This study China 13638.68 (2190.42)1 4624.15 (801.64)1 2015CNY (2015USD) Dean et al [52 ] United States 7737 (10398)2 2005USD (2015USD) Leong et al [23 ] United States 3736 (6175)2 791 (1307)2 1998USD (2015USD) Ricci et al [53 ] United States 7547 (11758)2 2000USD (2015USD) Ahn et al [54 ] United States 1562 (2294)2 2002USD (2015USD) Creed et al [55 ] United Kingdom 1743 (2634)3 334.50 (505.45)3 2003USD (2015USD)