Digestive Diseases and Sciences

, Volume 57, Issue 1, pp 109–118 | Cite as

Excess Comorbidity Prevalence and Cost Associated with Functional Dyspepsia in an Employed Population

  • Richard A. Brook
  • Nathan L. Kleinman
  • Rok Seon Choung
  • James E. Smeeding
  • Nicholas J. Talley
Original Article



Limited published data exist on the associated comorbid conditions with functional dyspepsia (FD).


This study aimed to assess the prevalence, services, and costs related to comorbid conditions associated with FD and the risk of having FD for each comorbid condition.


A retrospective database analysis was undertaken using payroll data and adjudicated claims from January 1, 2001, through December 31, 2004 among >300,000 employees. Employees with FD were compared to propensity-score-matched employees without FD (controls). Outcome measures included the prevalence, costs, and utilization of health services for comorbid conditions as defined by the Agency for Healthcare Research and Quality (AHRQ) and the odds ratios of having FD from a multivariate model.


FD employees (N = 1,669) and a 50:1 matched control cohort (N = 83,450) were compared. Compared to matched controls, FD employees were more likely to have all major diagnostic categories. Moreover, 199/261 of the AHRQ’s specific categories were more common in the FD cohort. Annual medical costs for the FD cohort were greater than for controls in 155/261 (59%) specific categories and significantly greater (P ≤ 0.05) in 76 categories (29%). Similarly, services were greater for 179/261 (69%) specific categories and significantly greater (P ≤ 0.05) in 110 categories (42%). In a multivariate model, esophageal disorders, gastritis and duodenitis, and abdominal pain were the most associated with having FD (odds ratios 3.8, 3.7, and 3.6, respectively). Only hypertension complications and disorders of the teeth and jaw were significantly negatively associated with FD.


There is unexplained excess comorbidity associated with FD which may be a major determining factor for excess healthcare services and costs.


Functional dyspepsia Comorbidities Costs Prevalence 



Functional dyspepsia


Agency for Healthcare Research and Quality


Functional gastrointestinal disorders


Irritable bowel syndrome


Human Capital Management Services


International Classification of Diseases, Ninth Revision


Major diagnostic categories


Consumer price indices



The authors would also like to acknowledge Stephen George, MS, RPh, formerly Vice President, Conexus Health, and Arthur K. Melkonian, MD, formerly of the HCMS Group, now of Promtest LLC, Yerevan, Armenia, for their assistance in the design and conduct of the original research. Dr. Melknonian also assisted in reviewing this manuscript. The original research support for this study was provided by Conexus Health, Tampa, FL. All subsequent analyses were not funded. The study sponsor provided funding and guidance on protocol development and interpretation of the data.

Conflict of interest

The corresponding author had full access to all of the data and takes full responsibility for the veracity of the data and statistical analysis.

The authors disclose the following: Richard Brook, Nathan Kleinman, and James Smeeding received consulting fees from Conexus Health associated with this research in 2004 and 2005. The remaining authors disclose no conflicts.


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Copyright information

© Springer Science+Business Media, LLC 2011

Authors and Affiliations

  • Richard A. Brook
    • 1
  • Nathan L. Kleinman
    • 2
  • Rok Seon Choung
    • 3
    • 4
  • James E. Smeeding
    • 5
  • Nicholas J. Talley
    • 3
    • 6
  1. 1.The JeSTARx GroupNewfoundlandUSA
  2. 2.The HCMS GroupPaso RoblesUSA
  3. 3.Department of Gastroenterology and HepatologyMayo Clinic College of MedicineRochesterUSA
  4. 4.Department of Gastroenterology and HepatologyKorea University College of MedicineSeoulKorea
  5. 5.The JeSTARx GroupDallasUSA
  6. 6.Faculty of HealthUniversity of NewcastleCallaghanAustralia

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