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Anemia Severity Associated with Increased Healthcare Utilization and Costs in Inflammatory Bowel Disease

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Abstract

Background

Anemia is a common systemic complication of inflammatory bowel disease (IBD) and is associated with worse disease outcomes, quality of life, and higher healthcare costs.

Aims

The purpose of this study was to determine how anemia severity impacts healthcare resource utilization and if treatment of anemia was associated with reduced utilization and costs.

Methods

Retrospective chart review of adult patients managed by gastroenterology between 2014 and 2018 at a tertiary referral center.

Results

The records of 1763 patients with IBD were included in the analysis, with 966 (55%) patients with CD, 799 (44%) with UC, and 18 (1%) with unspecified IBD. Of these patients, 951 (54%) had anemia. Patients with anemia had significantly more hospitalizations, increased length of stays, more ER, GI, and PCP visits, as well as higher costs when compared to patients with IBD without anemia. Patients with more severe anemia had more healthcare utilization and incurred even higher total costs. Treatment with IV or oral iron did not lower overall utilization or costs, when compared to patients with anemia who did not receive treatment (p < 0.0001).

Conclusions

Our results demonstrate that the presence of anemia is correlated with increased resource utilization in patients with IBD, with increase in anemia severity associated with higher utilization and costs. Anemia has been associated with increased disease activity and could represent a marker of more severe disease, possibly explaining these associations. Our results suggest that treating anemia is associated with increased resource utilization; however, further research is needed to investigate this relationship.

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Authors and Affiliations

  1. Department of Internal Medicine, Texas A&M Health Science Center College of Medicine, 2401 S 31st St, Temple, TX, 76508, USA

    Hanna Blaney

  2. Texas A&M Health Science Center College of Medicine, 2401 S 31st St, Temple, TX, 76508, USA

    Peter Vu, Antony Mathew, Robin Snelling, Julie England & Camille Duong

  3. Department of Biostatistics, Baylor Scott and White Research Institute, 2401 S 31st St, Temple, TX, 76508, USA

    Kendall Hammonds

  4. Division of Gastroenterology, Texas A&M Health Science Center College of Medicine, 2401 S 31st St, Temple, TX, 76508, USA

    Christopher Johnson

Authors
  1. Hanna Blaney
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  2. Peter Vu
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  3. Antony Mathew
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  4. Robin Snelling
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  5. Julie England
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  6. Camille Duong
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  7. Kendall Hammonds
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  8. Christopher Johnson
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Corresponding author

Correspondence to Christopher Johnson.

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Conflict of interest

The authors have no financial disclosures, conflicts of interests, or funding support to disclose.

Ethical approval

This study was approved by the Internal Review Board at Baylor Scott and White Health in Temple, TX, IRB Number 018-743. Given the retrospective nature of this study and minimal risk to patients, informed consent was waived.

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Blaney, H., Vu, P., Mathew, A. et al. Anemia Severity Associated with Increased Healthcare Utilization and Costs in Inflammatory Bowel Disease. Dig Dis Sci 66, 2555–2563 (2021). https://doi.org/10.1007/s10620-020-06590-y

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  • DOI: https://doi.org/10.1007/s10620-020-06590-y

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