Estimating medical costs of gastroenterological diseases

Abstract

AIM: To estimate the directmedical costs of gastroenterological\r\ndiseases within the universal health insurance program\r\namong the population of local residents in Taiwan.\r\nMETHODS: The data sources were the first 4 cohort\r\ndatasets of 200 000 people from the National Health\r\nInsurance Research Database in Taipei. The ambulatory,\r\ninpatient and pharmacy claims of the cohort in 2001 were\r\nanalyzed. Besides prevalence and medical costs of diseases,\r\nboth amount and costs of utilization in procedures and drugs\r\nwere calculated.\r\nRESULTS: Of the cohort with 183 976 eligible people, 44.2%\r\nhad ever a gastroenterological diagnosis during the year.\r\nThe age group 20-39 years had the lowest prevalence rate\r\n(39.2%) while the elderly had the highest (58.4%). The\r\nprevalence rate was higher in women than in men (48.5%\r\nvs. 40.0%). Totally, 30.4% of 14 888 inpatients had ever a\r\ngastroenterological diagnosis at discharge and 18.8% of\r\n51 359 patients at clinics of traditional Chinese medicine had\r\nsuch a diagnosis there. If only the principal diagnosis on each\r\nclaimwas considered, 16.2%of admissions, 8.0%of outpatient\r\nvisits, and 10.1%of the totalmedical costs (8 469 909 US dollars/\r\n83 830 239 US dollars) were attributed to gastroenterological\r\ndiseases. On average, 46.0 US dollars per insured person in\r\na year were spent in treating gastroenterological diseases.\r\nDiagnostic procedures related to gastroenterological diseases\r\naccounted for 24.2%of the costs for all diagnostic procedures\r\nand 2.3% of the total medical costs. Therapeutic procedures\r\nrelated to gastroenterological diseases accounted for 4.5%\r\nof the costs for all therapeutic procedures and 1.3% of the\r\ntotal medical costs. Drugs related to gastroenterological\r\ndiseases accounted for 7.3% of the costs for all drugs and\r\n1.9% of the total medical costs.\r\nCONCLUSION: Gastroenterological diseases are prevalent\r\namong the population of local residents in Taiwan, accounting\r\nfor a tenth of the total medical costs. Further investigations\r\nare needed to differentiate