Quantifying the relationship between disease severity, utility and health care resource use in Crohn's disease

Weston, A. R., Gibson, P. R., Florin, T., Macrae, F., Radford-Smith, G., Shann, A. and Lawrance, I. (2005). Quantifying the relationship between disease severity, utility and health care resource use in Crohn's disease. In: Josephine Mauskopf, Values in Health; ISPOR Eighth Annual European Congress Contributed Presentation Abstracts. ISPOR Eighth Annual European Congress, Florence, Italy, (A4-A4). 6-8 November 2005. doi:10.1016/S1098-3015(10)67152-5


Author Weston, A. R.
Gibson, P. R.
Florin, T.
Macrae, F.
Radford-Smith, G.
Shann, A.
Lawrance, I.
Title of paper Quantifying the relationship between disease severity, utility and health care resource use in Crohn's disease
Conference name ISPOR Eighth Annual European Congress
Conference location Florence, Italy
Conference dates 6-8 November 2005
Proceedings title Values in Health; ISPOR Eighth Annual European Congress Contributed Presentation Abstracts   Check publisher's open access policy
Journal name Value in Health   Check publisher's open access policy
Publisher nternational Society for Pharmacoeconomics and Outcomes Research; Wiley-Blackwell
Publication Year 2005
DOI 10.1016/S1098-3015(10)67152-5
ISSN 1098-3015
Editor Josephine Mauskopf
Volume 8
Issue 6
Start page A4
End page A4
Total pages 1
Language eng
Formatted Abstract/Summary
Objectives:  To assess the relationship between (i) disease
severity and quality of life and (ii) disease severity and health
care resource use, in patients with Crohn’s disease.

Methods:
A prospective, cross sectional, pharmacoeconomics study was
conducted in five centres in Australia, with patients recruited by
specialist gastroenterologists. Each patient completed questionnaires
comprising demographic, disease and health care utilisation
questions, together with the disease-specific Inflammatory
Bowel Disease Questionnaire (IBDQ) and the Assessment of
Quality of Life (AQoL) multi-attribute utility instrument.
Disease severity was assessed by the gastroenterologist, using the
Crohn’s Disease Activity Index (CDAI).

Results:
Of the 154
patients recruited, 11 were excluded due to incomplete datasets
or significant co-morbidity. The 143 patients analysed had a
broad range of disease severity (CDAI 36-446), and included
23% with enterocutaneous fistulae. Stepwise regression analyses
showed a negative relationship between disease severity and
quality of life—irrespective of whether the latter was measured
by the IBDQ (p < 0.0001) or the AQoL utility instrument (p <
0.0001). Age, gender and years since diagnosis did not significantly
impact upon either of the quality of life outcomes. Health
care resource utilisation increased with increasing CDAI (p <
0.001), with hospital admissions being the largest component
cost. Even when patients with fistulae were excluded, the mean
treatment cost for the most severe group (CDAI >= 220) was
AUD$7852 annually, excluding medications. Finally, despite
their young age (mean = 38yrs), 27% of patients received a Government
benefit; with the majority of these stating that this was
primarily due to their Crohn’s disease.

Conclusions:
More severe Crohn’s disease is associated with poor quality of life for
patients and places considerable burden upon health care and
social welfare resources.
Subjects 11 Medical and Health Sciences
1117 Public Health and Health Services
Keyword Health Care Sciences & Services
Health Policy & Services
Q-Index Code EX
Q-Index Status Provisional Code
Institutional Status Unknown

 
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Created: Mon, 13 Aug 2007, 15:39:17 EST