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. 2022 Feb;162(2):621-644.
doi: 10.1053/j.gastro.2021.10.017. Epub 2021 Oct 19.

Burden and Cost of Gastrointestinal, Liver, and Pancreatic Diseases in the United States: Update 2021

Anne F Peery  1 , Seth D Crockett  2 , Caitlin C Murphy  3 , Elizabeth T Jensen  4 , Hannah P Kim  2 , Matthew D Egberg  2 , Jennifer L Lund  5 , Andrew M Moon  2 , Virginia Pate  5 , Edward L Barnes  2 , Courtney L Schlusser  5 , Todd H Baron  2 , Nicholas J Shaheen  2 , Robert S Sandler  2
Affiliations

Burden and Cost of Gastrointestinal, Liver, and Pancreatic Diseases in the United States: Update 2021

Anne F Peery et al. Gastroenterology. 2022 Feb.

Abstract

Background & aims: Gastrointestinal diseases account for considerable health care use and expenditures. We estimated the annual burden, costs, and research funding associated with gastrointestinal, liver, and pancreatic diseases in the United States.

Methods: We generated estimates using data from the National Ambulatory Medical Care Survey; National Hospital Ambulatory Medical Care Survey; Nationwide Emergency Department Sample; National Inpatient Sample; Kids' Inpatient Database; Nationwide Readmissions Database; Surveillance, Epidemiology, and End Results program; National Vital Statistics System; Centers for Disease Control and Prevention Wide-Ranging Online Data for Epidemiologic Research; MarketScan Commercial Claims and Encounters data; MarketScan Medicare Supplemental data; United Network for Organ Sharing registry; Medical Expenditure Panel Survey; and National Institutes of Health (NIH).

Results: Gastrointestinal health care expenditures totaled $119.6 billion in 2018. Annually, there were more than 36.8 million ambulatory visits for gastrointestinal symptoms and 43.4 million ambulatory visits with a primary gastrointestinal diagnosis. Hospitalizations for a principal gastrointestinal diagnosis accounted for more than 3.8 million admissions, with 403,699 readmissions. A total of 22.2 million gastrointestinal endoscopies were performed, and 284,844 new gastrointestinal cancers were diagnosed. Gastrointestinal diseases and cancers caused 255,407 deaths. The NIH supported $3.1 billion (7.5% of the NIH budget) for gastrointestinal research in 2020.

Conclusions: Gastrointestinal diseases are responsible for millions of health care encounters and hundreds of thousands of deaths that annually costs billions of dollars in the United States. To reduce the high burden of gastrointestinal diseases, focused clinical and public health efforts, supported by additional research funding, are warranted.

Keywords: Digestive System Diseases; Endoscopy; Health Care Costs; Neoplasms.

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Figures

Figure 1A.
Figure 1A.
Age-adjusted incidence of esophageal cancer by race/ethnicity, National Cancer Institute’s Surveillance, Epidemiology, and End Results program of cancer registries, 1992 – 2018
Figure 1B.
Figure 1B.
Age-adjusted mortality of esophageal cancer, National Center of Health Statistics, 1992 – 2018
Figure 2A.
Figure 2A.
Age-adjusted incidence of colon and rectal cancer by race/ethnicity, National Cancer Institute’s Surveillance, Epidemiology, and End Results program of cancer registries, 1992 – 2018
Figure 2B.
Figure 2B.
Age-adjusted mortality of colon and rectal cancer, National Center of Health Statistics, 1992 –2018
Figure 3A.
Figure 3A.
Age-adjusted incidence of stomach cancer by race/ethnicity, National Cancer Institute’s Surveillance, Epidemiology, and End Results program of cancer registries, 1992 – 2018
Figure 3B.
Figure 3B.
Age-adjusted mortality of stomach cancer, National Center of Health Statistics, 1992 – 2018
Figure 4A.
Figure 4A.
Age-adjusted incidence of liver and intrahepatic bile duct cancer by race/ethnicity, National Cancer Institute’s Surveillance, Epidemiology, and End Results program of cancer registries, 1992 – 2018
Figure 4B.
Figure 4B.
Age-adjusted mortality of liver and intrahepatic bile duct cancer, National Center of Health Statistics, 1992 – 2018
Figure 5A.
Figure 5A.
Age-adjusted incidence of pancreas cancer by race/ethnicity, National Cancer Institute’s Surveillance, Epidemiology, and End Results program of cancer registries, 1992 – 2018
Figure 5B.
Figure 5B.
Age-adjusted mortality of pancreas cancer, National Center of Health Statistics, 1992 – 2018
Figure 6A.
Figure 6A.
Colonoscopies performed per 1,000 enrollee-years, by age group, MarketScan Commercial Claims and Encounters and Medicare Supplemental database, 2002–2019
Figure 6B.
Figure 6B.
Upper endoscopies performed per 1,000 enrollee-years, by age group, MarketScan Commercial Claims and Encounters and Medicare Supplemental database, 2002–2019
Figure 6C.
Figure 6C.
Flexible sigmoidoscopies performed per 1,000 enrollee-years, by age group, MarketScan Commercial Claims and Encounters and Medicare Supplemental database, 2002–2019
Figure 6D.
Figure 6D.
Endoscopic retrograde cholangiopancreatographies performed per 1,000 enrollee-years, by age group, MarketScan Commercial Claims and Encounters and Medicare Supplemental database, 2002–2019
Figure 6E.
Figure 6E.
Upper endoscopic ultrasound performed per 1,000 enrollee-years, by age group, MarketScan Commercial Claims and Encounters and Medicare Supplemental database, 2002–2019
Figure 6F.
Figure 6F.
Lower endoscopic ultrasound performed per 1,000 enrollee-years, by age group, MarketScan Commercial Claims and Encounters and Medicare Supplemental database, 2002–2019
Figure 7A.
Figure 7A.
Numbers of persons added to the waiting list and liver transplants performed, United Network for Organ Sharing registry, 1988–2020
Figure 7B.
Figure 7B.
Numbers of persons added to the waiting list and intestine transplants performed, United Network for Organ Sharing registry, 1988–2020
Figure 7C.
Figure 7C.
Numbers of persons added to the waiting list and pancreas transplants performed, United Network for Organ Sharing registry, 1988–2020
Figure 7D.
Figure 7D.
Numbers persons added to the waiting list and of kidney-pancreas transplants performed, United Network for Organ Sharing registry, 1988–2020
See this image and copyright information in PMC

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