Utilization patterns and net direct medical cost to Medicaid of irritable bowel syndrome

Abstract

Background: Patients with irritable bowel syndrome are frequent users of the health care system.

Design and methods: This retrospective matched case-control study assessed the economic impact of irritable bowel syndrome on the Medicaid program by comparing the health care utilization and expenditures of Medicaid patients with irritable bowel syndrome in California and North Carolina with age-, sex-, and race-matched control groups without the syndrome.

Results: Average annual Medicaid expenditures per case of diagnosed irritable bowel syndrome were 2952 dollars and 5908 dollars in California and North Carolina, respectively; corresponding unadjusted net incremental expenditures were 962 dollars and 2191 dollars, respectively. In both states, patients with irritable bowel syndrome incurred greater costs than controls for physician visits, outpatient visits, and prescription drugs.

Conclusions: Irritable bowel syndrome was shown to impose an economic burden on the Medicaid program. The cost of treating patients with irritable bowel syndrome is higher than the cost of treating matched ambulatory Medicaid recipients without the condition.