Burden of Gastrointestinal, Liver, and Pancreatic Diseases in the United States

Abstract

Background & aims: Gastrointestinal (GI), liver, and pancreatic diseases are a source of substantial morbidity, mortality, and cost in the United States. Quantification and statistical analyses of the burden of these diseases are important for researchers, clinicians, policy makers, and public health professionals. We gathered data from national databases to estimate the burden and cost of GI and liver disease in the United States.

Methods: We collected statistics on health care utilization in the ambulatory and inpatient setting along with data on cancers and mortality from 2007 through 2012. We included trends in utilization and charges. The most recent data were obtained from the Centers for Disease Control and Prevention, the Agency for Healthcare Research and Quality, and the National Cancer Institute.

Results: There were 7 million diagnoses of gastroesophageal reflux and almost 4 million diagnoses of hemorrhoids in the ambulatory setting in a year. Functional and motility disorders resulted in nearly 1 million emergency department visits in 2012; most of these visits were for constipation. GI hemorrhage was the most common diagnosis leading to hospitalization, with >500,000 discharges in 2012, at a cost of nearly $5 billion dollars. Hospitalizations and associated charges for inflammatory bowel disease, Clostridium difficile infection, and chronic liver disease have increased during the last 20 years. In 2011, there were >1 million people in the United States living with colorectal cancer. The leading GI cause of death was colorectal cancer, followed by pancreatic and hepatobiliary neoplasms.

Conclusions: GI, liver and pancreatic diseases are a source of substantial burden and cost in the United States.

Keywords: Abdominal Pain; GERD; Gastrointestinal Hemorrhage; IBS.

FIGURE 1A

Rising number of hospitalizations with associated or principal Clostridium difficile infection diagnoses

FIGURE 1B

Rising charges for hospitalizations with principal Clostridium difficile infection diagnoses

FIGURE 1C

Rising number of hospitalizations with principal diagnosis of inflammatory bowel disease, including Crohn’s disease or ulcerative colitis

FIGURE 1D

Rising charges for hospitalizations for inflammatory bowel disease, including Crohn’s disease or ulcerative colitis

FIGURE 1E

Rising number of hospitalizations with principal diagnosis of liver disease

FIGURE 1F

Rising charges for hospitalizations for principal diagnosis of liver disease