Effect of phenotype on health care costs in Crohn's disease: A European study using the Montreal classification

European Collaborative Study Group on Inflammatory Bowel Disease

doi:10.1016/j.crohns.2007.08.004

Effect of phenotype on health care costs in Crohn's disease: A European study using the Montreal classification

European Collaborative Study Group on Inflammatory Bowel Disease

Department of Clinical Medicine

14 Citations (Scopus)

Abstract

BACKGROUND: Crohn's disease (CD) is a chronic inflammation of the gastrointestinal tract associated with life-long high health care costs. We aimed to determine the effect of disease phenotype on cost.

METHODS: Clinical and economic data of a community-based CD cohort with 10-year follow-up were analyzed retrospectively in relation to Montreal classification phenotypes.

RESULTS: In 418 patients, mean total costs of health care for the behavior phenotypes were: nonstricturing-nonpenetrating 1690, stricturing 2081, penetrating 3133 and penetrating-with-perianal-fistula 3356 €/patient-phenotype-year (P<0.001), and mean costs of surgical hospitalization 215, 751, 1293 and 1275 €/patient-phenotype-year respectively (P<0.001). Penetrating-with-perianal-fistula patients incurred significantly greater expenses than penetrating patients for total care, diagnosis and drugs, but not surgical hospitalization. Total costs were similar in the location phenotypes: ileum 1893, colon 1748, ileo-colonic 2010 and upper gastrointestinal tract 1758 €/patient-phenotype-year, but surgical hospitalization costs differed significantly, 558, 209, 492 and 542 €/patient-phenotype-year respectively (P<0.001). By multivariate analysis, the behavior phenotype significantly impacted total, medical and surgical hospitalization costs, whereas the location phenotype affected only surgical costs. Younger age at diagnosis predicted greater surgical expenses.

CONCLUSIONS: Behavior is the dominant phenotype driving health care cost. Use of the Montreal classification permits detection of cost differences caused by perianal fistula.

Original language	English
Journal	Journal of Crohn's & colitis
Volume	1
Issue number	2
Pages (from-to)	87-96
Number of pages	10
ISSN	1873-9946
DOIs	https://doi.org/10.1016/j.crohns.2007.08.004
Publication status	Published - Dec 2007

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10.1016/j.crohns.2007.08.004

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@article{c0284abe43e441079e54a950c7792fbe,

title = "Effect of phenotype on health care costs in Crohn's disease: A European study using the Montreal classification",

abstract = "BACKGROUND: Crohn's disease (CD) is a chronic inflammation of the gastrointestinal tract associated with life-long high health care costs. We aimed to determine the effect of disease phenotype on cost.METHODS: Clinical and economic data of a community-based CD cohort with 10-year follow-up were analyzed retrospectively in relation to Montreal classification phenotypes.RESULTS: In 418 patients, mean total costs of health care for the behavior phenotypes were: nonstricturing-nonpenetrating 1690, stricturing 2081, penetrating 3133 and penetrating-with-perianal-fistula 3356 €/patient-phenotype-year (P<0.001), and mean costs of surgical hospitalization 215, 751, 1293 and 1275 €/patient-phenotype-year respectively (P<0.001). Penetrating-with-perianal-fistula patients incurred significantly greater expenses than penetrating patients for total care, diagnosis and drugs, but not surgical hospitalization. Total costs were similar in the location phenotypes: ileum 1893, colon 1748, ileo-colonic 2010 and upper gastrointestinal tract 1758 €/patient-phenotype-year, but surgical hospitalization costs differed significantly, 558, 209, 492 and 542 €/patient-phenotype-year respectively (P<0.001). By multivariate analysis, the behavior phenotype significantly impacted total, medical and surgical hospitalization costs, whereas the location phenotype affected only surgical costs. Younger age at diagnosis predicted greater surgical expenses.CONCLUSIONS: Behavior is the dominant phenotype driving health care cost. Use of the Montreal classification permits detection of cost differences caused by perianal fistula.",

author = "Selwyn Odes and Hillel Vardi and Michael Friger and Frank Wolters and Ole Hoie and Bj{\o}rn Moum and Tomm Bernklev and Hagit Yona and Maurice Russel and Pia Munkholm and Ebbe Langholz and Lene Riis and Patrizia Politi and Paolo Bondini and Epameinondas Tsianos and Kostas Katsanos and Juan Clofent and Severine Vermeire and Jo{\~a}o Freitas and Iannis Mouzas and Charles Limonard and Colm O'Morain and Estela Monteiro and Giovanni Fornaciari and Morten Vatn and Reinhold Stockbrugger and {European Collaborative Study Group on Inflammatory Bowel Disease}",

year = "2007",

month = dec,

doi = "10.1016/j.crohns.2007.08.004",

language = "English",

volume = "1",

pages = "87--96",

journal = "Journal of Crohn's and Colitis",

issn = "1873-9946",

publisher = "Oxford University Press",

number = "2",

}

TY - JOUR

T1 - Effect of phenotype on health care costs in Crohn's disease

T2 - A European study using the Montreal classification

AU - Odes, Selwyn

AU - Vardi, Hillel

AU - Friger, Michael

AU - Wolters, Frank

AU - Hoie, Ole

AU - Moum, Bjørn

AU - Bernklev, Tomm

AU - Yona, Hagit

AU - Russel, Maurice

AU - Munkholm, Pia

AU - Langholz, Ebbe

AU - Riis, Lene

AU - Politi, Patrizia

AU - Bondini, Paolo

AU - Tsianos, Epameinondas

AU - Katsanos, Kostas

AU - Clofent, Juan

AU - Vermeire, Severine

AU - Freitas, João

AU - Mouzas, Iannis

AU - Limonard, Charles

AU - O'Morain, Colm

AU - Monteiro, Estela

AU - Fornaciari, Giovanni

AU - Vatn, Morten

AU - Stockbrugger, Reinhold

AU - European Collaborative Study Group on Inflammatory Bowel Disease

PY - 2007/12

Y1 - 2007/12

N2 - BACKGROUND: Crohn's disease (CD) is a chronic inflammation of the gastrointestinal tract associated with life-long high health care costs. We aimed to determine the effect of disease phenotype on cost.METHODS: Clinical and economic data of a community-based CD cohort with 10-year follow-up were analyzed retrospectively in relation to Montreal classification phenotypes.RESULTS: In 418 patients, mean total costs of health care for the behavior phenotypes were: nonstricturing-nonpenetrating 1690, stricturing 2081, penetrating 3133 and penetrating-with-perianal-fistula 3356 €/patient-phenotype-year (P<0.001), and mean costs of surgical hospitalization 215, 751, 1293 and 1275 €/patient-phenotype-year respectively (P<0.001). Penetrating-with-perianal-fistula patients incurred significantly greater expenses than penetrating patients for total care, diagnosis and drugs, but not surgical hospitalization. Total costs were similar in the location phenotypes: ileum 1893, colon 1748, ileo-colonic 2010 and upper gastrointestinal tract 1758 €/patient-phenotype-year, but surgical hospitalization costs differed significantly, 558, 209, 492 and 542 €/patient-phenotype-year respectively (P<0.001). By multivariate analysis, the behavior phenotype significantly impacted total, medical and surgical hospitalization costs, whereas the location phenotype affected only surgical costs. Younger age at diagnosis predicted greater surgical expenses.CONCLUSIONS: Behavior is the dominant phenotype driving health care cost. Use of the Montreal classification permits detection of cost differences caused by perianal fistula.

AB - BACKGROUND: Crohn's disease (CD) is a chronic inflammation of the gastrointestinal tract associated with life-long high health care costs. We aimed to determine the effect of disease phenotype on cost.METHODS: Clinical and economic data of a community-based CD cohort with 10-year follow-up were analyzed retrospectively in relation to Montreal classification phenotypes.RESULTS: In 418 patients, mean total costs of health care for the behavior phenotypes were: nonstricturing-nonpenetrating 1690, stricturing 2081, penetrating 3133 and penetrating-with-perianal-fistula 3356 €/patient-phenotype-year (P<0.001), and mean costs of surgical hospitalization 215, 751, 1293 and 1275 €/patient-phenotype-year respectively (P<0.001). Penetrating-with-perianal-fistula patients incurred significantly greater expenses than penetrating patients for total care, diagnosis and drugs, but not surgical hospitalization. Total costs were similar in the location phenotypes: ileum 1893, colon 1748, ileo-colonic 2010 and upper gastrointestinal tract 1758 €/patient-phenotype-year, but surgical hospitalization costs differed significantly, 558, 209, 492 and 542 €/patient-phenotype-year respectively (P<0.001). By multivariate analysis, the behavior phenotype significantly impacted total, medical and surgical hospitalization costs, whereas the location phenotype affected only surgical costs. Younger age at diagnosis predicted greater surgical expenses.CONCLUSIONS: Behavior is the dominant phenotype driving health care cost. Use of the Montreal classification permits detection of cost differences caused by perianal fistula.

U2 - 10.1016/j.crohns.2007.08.004

DO - 10.1016/j.crohns.2007.08.004

M3 - Journal article

C2 - 21172190

SN - 1873-9946

VL - 1

SP - 87

EP - 96

JO - Journal of Crohn's and Colitis

JF - Journal of Crohn's and Colitis

IS - 2

ER -

Effect of phenotype on health care costs in Crohn's disease: A European study using the Montreal classification

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