Healthcare Burdens Across All Gastric-Related Disorders: More Understanding, Less Impairment?
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EDITORIAL
Healthcare Burdens Across All Gastric‑Related Disorders: More Understanding, Less Impairment? Helen Burton Murray1,2,3,4 · Braden Kuo1,3
© Springer Science+Business Media, LLC, part of Springer Nature 2020
Chronic gastric-related conditions such as gastroparesis and functional dyspepsia are associated with significant qualityof-life impairment. Data derived from cross-sectional cohort samples suggest poor physical- and mental- health-related quality-of-life [1, 2], health-related costs (e.g., co-payments, medication costs) [3], and work impairment [2, 3]. Nevertheless, much of these data have been amassed from tertiary care center reports, including the NIH gastroparesis consortium [1, 4, 5]. Several studies have examined quality-of-life impairments in large community samples [6] and healthcare burdens in inpatient databases [7–9], but have been largely limited to gastroparesis samples. Thus, more data have been needed addressing the burdens engendered across the entire spectrum of gastric-related disorders among the broader population and across levels of care. In this issue of Digestive Disease and Sciences, Bielefeldt [10] describes trends in healthcare utilization and functional impairment based on data gathered by the Medical Expenditure Panel Survey (MEPS) collected between 2000 and 2015 that studied 10,699 individuals with gastric-related conditions. One area that has been largely unaddressed by prior research is the burden of gastric-related conditions outside of the tertiary care setting, since tertiary care patients may be more likely to have greater illness severity. Bielefeldt [10] addresses this issue by using the MEPS, a publicly available database of a US population-based survey of acute and chronic medical conditions, collected through in-person household interviews by the National Health Interview * Helen Burton Murray [email protected] 1
Harvard Medical School, Boston, MA, USA
2
Eating Disorders Clinical and Research Program, Massachusetts General Hospital, Boston, MA, USA
3
Center for Neurointestinal Health, Gastroenterology, Massachusetts General Hospital, Boston, MA, USA
4
Department of Psychiatry, Massachusetts General Hospital, Boston, MA, USA
Survey. Using this large database, the author selected individuals who had self-reported “disorders of function of the stomach” (ICD-9 code 536) which includes the codes for achlorhydria, acute dilation of the stomach, persistent vomiting, gastroparesis, gastrostomy complications, dyspepsia and unspecified functional gastric disorder. Importantly, Bielefeldt [10] found that healthcare utilization related to the gastric condition was actually lower than the reference cohort (i.e., presumably all individuals in the database without ICD-9 code 536), and lower than many rates reported from tertiary care gastroparesis samples. While the group of individuals with gastric-related conditions in Bielefeldt [10] had a significantly greater average utilization of office visits, ambulatory visits, hospitalizations, and prescript
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