Burden and Cost of Gastrointestinal, Liver, and Pancreatic Diseases in the United States: Update 2018
Open accessAbstract
Background & aims Estimates of disease burden can inform national health priorities for research, clinical care, and policy. We aimed to estimate health care use and spending among gastrointestinal (GI) (including luminal, liver, and pancreatic) diseases in the United States.Methods We estimated health care use and spending based on the most currently available administrative claims from commercial and Medicare Supplemental plans, data from the GI Quality Improvement Consortium Registry, and national databases.Results In 2015, annual health care expenditures for gastrointestinal diseases totaled $135.9 billion. Hepatitis ($23.3 billion), esophageal disorders ($18.1 billion), biliary tract disease ($10.3 billion), abdominal pain ($10.2 billion), and inflammatory bowel disease ($7.2 billion) were the most expensive. Yearly, there were more than 54.4 million ambulatory visits with a primary diagnosis for a GI disease, 3.0 million hospital admissions, and 540,500 all-cause 30-day readmissions. There were 266,600 new cases of GI cancers diagnosed and 144,300 cancer deaths. Each year, there were 97,700 deaths from non-malignant GI diseases. An estimated 11.0 million colonoscopies, 6.1 million upper endoscopies, 313,000 flexible sigmoidoscopies, 178,400 upper endoscopic ultrasound examinations, and 169,500 endoscopic retrograde cholangiopancreatography procedures were performed annually. Among average-risk persons aged 50-75 years who underwent colonoscopy, 34.6% had 1 or more adenomatous polyps, 4.7% had 1 or more advanced adenomatous polyps, and 5.7% had 1 or more serrated polyps removed.Conclusions GI diseases contribute substantially to health care use in the United States. Total expenditures for GI diseases are $135.9 billion annually-greater than for other common diseases. Expenditures are likely to continue increasing.
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- Authors
- Peery, A. F., Crockett, S. D., Murphy, C. C., Lund, J. L., Dellon, E. S., Williams, J. L., Jensen, E. T., Shaheen, N. J., Barritt, A. S., Lieber, S. R., Kochar, B., Barnes, E. L., Fan, Y. C., Pate, V., Galanko, J., Baron, T. H., & Sandler, R. S.
- Affiliations
- University of North Carolina at Chapel Hill (US)
- The University of Texas Southwestern Medical Center (US)
- Wake Forest University Health Sciences (US)
- Corresponding author
- Peery, Anne F.
- ORCID
- Venue
- Gastroenterology
- Publisher
- Elsevier BV
- Published
- 2019-01
- Volume
- 156
- Issue
- 1
- Pages
- 254-272.e11
- ISSN
- 0016-5085 (ISSN-L)
- PMC
- PMC6689327
- OpenAlex
- W2897031692
- Cited by
- 1,619
- References
- 39
- Citations by year
- 2026: 87 · 2025: 174 · 2024: 217 · 2023: 245 · 2022: 272 · 2021: 287 · 2020: 228 · 2019: 101 · 2018: 3 · 2017: 1 · 2013: 1 · 2012: 1
- FWCI
- 41.40
- Type
- journal article
- Language
- en
- Update notices
- erratum (2019-05-01)
- Open access
- green
- www.ncbi.nlm.nih.gov
- Locations
- Gastroenterology (publishedVersion)
- PubMed (publishedVersion)
- PubMed Central (acceptedVersion)
- Carolina Digital Repository (University of North Carolina at Chapel Hill) (submittedVersion)
- Funders
- National Institutes of Health (K23DK113225, KL2TR001103, KL2TR001109, T32 DK07634)
- Topics
- Social Sciences › Economics, Econometrics and Finance › Economics and Econometrics › Healthcare Policy and Management
- Health Sciences › Medicine › Epidemiology › Chronic Disease Management Strategies
- Social Sciences › Economics, Econometrics and Finance › Economics and Econometrics › Health Systems, Economic Evaluations, Quality of Life
- Keywords
- gastrointestinal diseases, liver disease, pancreatic diseases, health care expenditure, disease burden, health care utilization, hospitalization, 30-day readmission, gastrointestinal cancer, hepatitis, esophageal diseases, biliary tract diseases, abdominal pain, inflammatory bowel disease, colonoscopy, adenomatous polyps, serrated polyps, endoscopy
- MeSH terms
- Adolescent, Adult, Aged, Health Expenditures, Female, Gastrointestinal Diseases, Health Services Needs and Demand, Humans, Liver Diseases, Male, Middle Aged, Pancreatic Diseases, Socioeconomic Factors, Time Factors, United States, Incidence, Prevalence, Health Care Costs, Cost of Illness, Needs Assessment, Young Adult
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