Treatment costs for the group of patients with non-specific inflammatory bowel disease during acute exacerbation and further annual observation

Introduction : The problem of costs related to health care services is particularly important in the case of chronic diseases, among which non-specific inflammatory bowel diseases (IBD) are classified.

Aim : To analyse the costs of health care services determined by the National Health Fund (NFZ) during annual medical care for patients with IBD from the moment of inception of treatment of acute exacerbation.

Material and methods : The study was conducted in 2004-2007 in 41 patients diagnosed with Crohn’s disease (CD) (14 people) or ulcerative colitis (UC) (27 people). The study was initiated during an acute exacerbation. At the beginning of the study and during the final visit the history data concerning the occupational activity of the sick person was taken. During the observation the duration of inability to work because of IBD was noted. After a year, information about the amount of health care services and their costs incurred by the NFZ funds was obtained from the hospital database. The study protocol was approved by the Bioethics Committee at the Collegium Medicum of Bydgoszcz.

Results : The average annual cost of treating a patient with IBD calculated on the basis of the income of the Hospital from the NFZ for provided health care services amounted to 10 298 PLN (in CD – 12 623 PLN and in UC – 9 092 PLN). Hospitalizations generated 95.8% of total costs. Costs of surgical treatment constituted 34.8% of the costs of hospitalization, and costs of biological treatment 14.5%. The cost of biological and surgical treatment per patient using health care services was comparable and amounted to 20 121 PLN (for surgical treatment) and 19 500 PLN (for biological treatment). The highest unit cost concerned the treatment of a patient with acute exacerbation of ulcerative colitis resistant to conventional therapy and was mainly associated with surgical treatment and postoperative complications.

Conclusions : The main direct costs in IBD are associated with hospitalizations, with a high percentage related to surgical and biological treatment. Factors that will reduce the need for hospitalization or shorten its duration are economically beneficial. An alternative to current surgical treatment of patients with non-specific inflammatory bowel disease is biological therapy, which has many advantages. This method of treatment requires careful assessment over time of its application because of the short time since its introduction. In Poland, patients with non-specific inflammatory bowel disease, despite generally low financial outlays for health care and financial underestimation of the health services provided to patients, are treated in accordance with applicable standards.