Time Trends in Healthcare Utilization Due to Self-Reported Functional Diseases of the Stomach
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ORIGINAL ARTICLE
Time Trends in Healthcare Utilization Due to Self‑Reported Functional Diseases of the Stomach Klaus Bielefeldt1,2 Received: 23 September 2019 / Accepted: 14 February 2020 © This is a U.S. Government work and not under copyright protection in the US; foreign copyright protection may apply 2020
Abstract Introduction Cohort studies from referral centers suggest an increasing burden of functional gastric disorders, with frequent emergency room (ER) visits, hospitalizations, or absenteeism. We hypothesized that recruitment from tertiary care sites skews results and thus investigated the burden of these illnesses, using the population-based data of the Medical Expenditure Panel Survey (MEPS). Methods Using MEPS data for the years 2000–2015, demographic, economic, healthcare-related, and quality-of-life indicators were extracted for adults reporting the diagnosis of functional gastric diseases to assess trends and to compare results with data from all adults surveyed. Results Between 2000 and 2015, 2.7 ± 0.2% of the adults surveyed reported a functional gastric illness. Within the period studied, 28.8 ± 2.8% and 17.9 ± 1.6% of this cohort reported ER visits or hospitalizations, respectively. Only a fraction of these persons attributed the ER visits (22.6 ± 0.9%) or admissions (10.9 ± 0.8%) to the functional gastric disorder. Rates remained stable rates during the period studied. Female sex, measures of physical function, comorbidities, and an income below the poverty line were predictors of healthcare utilization. While utilization was stable over time, annual costs increased by 113.9 ± 16.6% during the study period, outpacing the inflation rate of 37.6%. Conclusions Persons with functional gastric disorders have significant healthcare needs and face increasing costs of care, largely due to coexisting illnesses. While it is important to recognize this impact, the need for emergency care or hospitalizations remained stable and lower than reported for patients seen in tertiary referral centers, providing reassuring information for patients and providers. Keywords Medical expenditure panel · Functional dyspepsia · Gastroparesis · Healthcare resource utilization
Introduction Functional dyspepsia and gastroparesis fall into the category of functional gastric disorders, which are common chronic conditions that involve the brain–gut axis and affect an estimated 5% of the general population [1, 2]. Impaired emptying, altered accommodation, changes in visceral sensation, Electronic supplementary material The online version of this article (https://doi.org/10.1007/s10620-020-06154-0) contains supplementary material, which is available to authorized users. * Klaus Bielefeldt [email protected] 1
Section of Gastroenterology, George E. Wahlen VA Medical Center, 500 Foothill Dr, Salt Lake City, UT 84148, USA
University of Utah, Salt Lake City, USA
2
and abnormal processing of visceral sensory input all contribute to the development of dyspeptic symptoms [3–5]. While gastroparesis has typicall
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