Abstracts Division 2

31. The socioeconomic impact of irritable bowel syndrome: an analysis of direct and indirect healthcare costs

Michelle H.M.A. Bosman, MD*1,2, Zsa Zsa R.M. Weerts, MD, PhD*1,2, Johanna T.W. Snijkers, MD1,2, Lisa Vork, MD, PhD1,2, Zlatan Mujagic, MD, PhD1,2, Ad A.M. Masclee, MD, PhD1,2, Daisy M.A.E. Jonkers, PhD1,2, Daniel Keszthelyi, MD, PhD1,2.

*
These authors contributed equally to this manuscript.
1Division of Gastroenterology-Hepatology, Department of Internal Medicine, Maastricht University Medical Center+, Maastricht, the Netherlands.
2NUTRIM, School of Nutrition and Translational Research in Metabolism, Maastricht University, Maastricht, the Netherlands.

Background and aims
Irritable bowel syndrome (IBS) is associated with substantial costs to society. Extensive data on direct costs (healthcare consumption) and indirect costs (health-related productivity loss) are lacking. Hence, we examined the socioeconomic costs of IBS and assessed which sociodemographic and clinical patient characteristics are associated with higher costs.

Methods

Cross-sectional data from three Rome-defined Dutch IBS patient cohorts (n=419) were collected. Direct and indirect costs were evaluated using validated questionnaires (i.e., medical cost questionnaire and productivity cost questionnaire, respectively). Bootstrapped mean quarterly costs per IBS patient were calculated. Multivariable regression analyses were performed to identify variables associated with higher costs.

Results

Quarterly mean total costs per patient were €2.156 (95% CI €1793-2541), consisting of €802 (€625-1010) direct costs and €1.354 (€1072-1670) indirect costs. Direct costs consisted primarily of healthcare professional consultations, with costs related to gastrointestinal (GI) clinic visits accounting for 6% and costs related to mental healthcare visits for 20%. Higher direct costs were significantly associated with older age (p=0.007), unemployment (p=0.001), IBS subtypes other than constipation (p=0.033), lower disease specific quality of life (p=0.027), and more severe depressive symptoms (p=0.001). Indirect costs consisted of absenteeism (45%), presenteeism (42%), and productivity loss related to unpaid labour (13%) and were significantly associated with male sex (p=0.014) and more severe depressive symptoms (p=0.047).

Conclusion

Productivity loss is the main contributor to the socioeconomic burden of IBS. Direct costs were not predominantly related to GI care, but rather to mental healthcare. Awareness of the nature of costs and contributing patient factors should lead to optimisation of IBS management and a significant socioeconomic benefit for society.

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