A Nationwide 2010-2012 Analysis of U.S. Health Care Utilization in Inflammatory Bowel Diseases

作者：van Deen Welmoed K; van Oijen Martijn G H; Myers Kelly D; Centeno Adriana; Howard William; Choi Jennifer M; Roth Bennett E; McLaughlin Erin M; Hollander Daniel; Wong Swanson Belinda; Sack Jonathan; Ong Michael K; Ha Christina Y; Esrailian Eric; Hommes Daniel W^*

来源：Inflammatory Bowel Diseases, 2014, 20(10): 1747-1753.

DOI：10.1097/MIB.0000000000000139

• inflammatory bowel diseases
• health care utilization
• guidelines
• costs

Background: Implementation of the 2010 Affordable Care Act (ACA) calls for a collaborative effort to transform the U.S. health care system toward patient-centered and value-based care. To identify how specialty care can be improved, we mapped current U.S. health care utilization in patients with inflammatory bowel diseases (IBD) using a national insurance claims database. %26lt;br%26gt;Methods: We performed a cross-sectional study analyzing U.S. health care utilization in 964,633 patients with IBD between 2010 and 2012 using insurance claims data, including pharmacy and medical claims. Frequency of IBD-related care utilization (medication, tests, and treatments) and their charges were evaluated. Subsequently, outcomes were put into the framework of current U.S. guidelines to identify areas of improvement. %26lt;br%26gt;Results: A disproportionate usage of aminosalicylates in Crohn%26apos;s disease (42%), frequent corticosteroid use (46%, with 9% long-term users), and low rates of corticosteroid-sparing drugs (thiopurines 15%; methotrexate 2.7%) were observed. Markers for inflammatory activity, such as C-reactive protein or fecal calprotectin were not commonly used (8.8% and 0.13%, respectively). Although infrequently used (11%), anti-TNF antibody therapy represents a major part of observed IBD charges. %26lt;br%26gt;Conclusions: This analysis shows 2010-2012 utilization and medication patterns of IBD health care in the United States and suggests that improvement can be obtained through enhanced guidelines adherence.

• 出版日期2014-10