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

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Abstract

Background

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

Aims

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.

Methods

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.

Results

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.

Conclusion

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

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Abbreviations

FD:

Functional dyspepsia

AHRQ:

Agency for Healthcare Research and Quality

FGIDs:

Functional gastrointestinal disorders

IBS:

Irritable bowel syndrome

HCMS:

Human Capital Management Services

ICD-9:

International Classification of Diseases, Ninth Revision

MDCs:

Major diagnostic categories

CPIs:

Consumer price indices

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Acknowledgments

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.

Author information

Authors and Affiliations

  1. The JeSTARx Group, 18 Hirth Drive , Newfoundland, NJ, 07435-1710, USA

    Richard A. Brook

  2. The HCMS Group, 405 Cool Valley Road, Paso Robles, CA, 93446, USA

    Nathan L. Kleinman

  3. Department of Gastroenterology and Hepatology, Mayo Clinic College of Medicine, 200 First Street SW, Rochester, MN, 55905, USA

    Rok Seon Choung & Nicholas J. Talley

  4. Department of Gastroenterology and Hepatology, Korea University College of Medicine, Seoul, Korea

    Rok Seon Choung

  5. The JeSTARx Group, 4029 Gilbert Ave., Dallas, TX, 75219, USA

    James E. Smeeding

  6. Faculty of Health, University of Newcastle, Bowman Building, Callaghan, NSW, 2308, Australia

    Nicholas J. Talley

Authors
  1. Richard A. Brook
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  2. Nathan L. Kleinman
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  3. Rok Seon Choung
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  4. James E. Smeeding
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  5. Nicholas J. Talley
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Corresponding author

Correspondence to Richard A. Brook.

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Brook, R.A., Kleinman, N.L., Choung, R.S. et al. Excess Comorbidity Prevalence and Cost Associated with Functional Dyspepsia in an Employed Population. Dig Dis Sci 57, 109–118 (2012). https://doi.org/10.1007/s10620-011-1822-8

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  • DOI: https://doi.org/10.1007/s10620-011-1822-8

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