Burden and Cost of Gastrointestinal, Liver, and Pancreatic Diseases in the United States: Update 2018

Anne F Peery, Seth David Crockett, Caitlin C. Murphy, Jennifer LEIGH Lund, Evan S Dellon, J. Lucas Williams, Elizabeth T. Jensen, Nicholas J Shaheen, Alfred S. Barritt, Sarah R. Lieber, Bharati Kochar, Edward L. Barnes, Y. Claire Fan, Virginia Pate, Joseph A Galanko, Todd Huntley Baron, Robert S. Sandler

Research output: Contribution to journalReview article

Abstract

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.

LanguageEnglish (US)
Pages254-272.e11
JournalGastroenterology
Volume156
Issue number1
DOIs
StatePublished - Jan 1 2019

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Pancreatic Diseases
Cost of Illness
Gastrointestinal Diseases
Liver Diseases
Health Expenditures
Delivery of Health Care
Adenomatous Polyps
Colonoscopy
Biliary Tract Diseases
Sigmoidoscopy
Health Priorities
Gastrointestinal Neoplasms
Endoscopic Retrograde Cholangiopancreatography
Medicare
Quality Improvement
Polyps
Inflammatory Bowel Diseases
Abdominal Pain
Hepatitis
Endoscopy

Keywords

  • Digestive System Diseases
  • Endoscopy
  • Health Care Costs
  • Neoplasms

ASJC Scopus subject areas

  • Hepatology
  • Gastroenterology

Cite this

Burden and Cost of Gastrointestinal, Liver, and Pancreatic Diseases in the United States : Update 2018. / Peery, Anne F; Crockett, Seth David; Murphy, Caitlin C.; Lund, Jennifer LEIGH; Dellon, Evan S; Williams, J. Lucas; Jensen, Elizabeth T.; Shaheen, Nicholas J; Barritt, Alfred S.; Lieber, Sarah R.; Kochar, Bharati; Barnes, Edward L.; Fan, Y. Claire; Pate, Virginia; Galanko, Joseph A; Baron, Todd Huntley; Sandler, Robert S.

In: Gastroenterology, Vol. 156, No. 1, 01.01.2019, p. 254-272.e11.

Research output: Contribution to journalReview article

Peery, AF, Crockett, SD, Murphy, CC, Lund, JLEIGH, Dellon, ES, Williams, JL, Jensen, ET, Shaheen, NJ, Barritt, AS, Lieber, SR, Kochar, B, Barnes, EL, Fan, YC, Pate, V, Galanko, JA, Baron, TH & Sandler, RS 2019, 'Burden and Cost of Gastrointestinal, Liver, and Pancreatic Diseases in the United States: Update 2018', Gastroenterology, vol. 156, no. 1, pp. 254-272.e11. https://doi.org/10.1053/j.gastro.2018.08.063
Peery, Anne F ; Crockett, Seth David ; Murphy, Caitlin C. ; Lund, Jennifer LEIGH ; Dellon, Evan S ; Williams, J. Lucas ; Jensen, Elizabeth T. ; Shaheen, Nicholas J ; Barritt, Alfred S. ; Lieber, Sarah R. ; Kochar, Bharati ; Barnes, Edward L. ; Fan, Y. Claire ; Pate, Virginia ; Galanko, Joseph A ; Baron, Todd Huntley ; Sandler, Robert S. / Burden and Cost of Gastrointestinal, Liver, and Pancreatic Diseases in the United States : Update 2018. In: Gastroenterology. 2019 ; Vol. 156, No. 1. pp. 254-272.e11.
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AU - Dellon, Evan S

AU - Williams, J. Lucas

AU - Jensen, Elizabeth T.

AU - Shaheen, Nicholas J

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AU - Kochar, Bharati

AU - Barnes, Edward L.

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