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Gastro-oesophageal reflux disease increases healthcare use and medical costs in patients with bronchiectasis: a Korean nationwide population-based study

BACKGROUND: Gastro-oesophageal reflux disease (GORD) is not only a common aetiology but also accompanying comorbidity of non-cystic fibrosis bronchiectasis (bronchiectasis). However, the association between GORD and the disease burden of bronchiectasis has not been well evaluated. Our study aimed to...

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Autores principales: Yoon, Jai Hoon, Kim, Sang Hyuk, Ryu, Jiin, Chung, Sung Jun, Kim, Youlim, Yoon, Chang Ki, Ra, Seung Won, Oh, Yeon Mok, Choi, Hayoung, Lee, Hyun
Formato: Online Artículo Texto
Lenguaje:English
Publicado: SAGE Publications 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8721380/
https://www.ncbi.nlm.nih.gov/pubmed/34987606
http://dx.doi.org/10.1177/17562848211062801
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author Yoon, Jai Hoon
Kim, Sang Hyuk
Ryu, Jiin
Chung, Sung Jun
Kim, Youlim
Yoon, Chang Ki
Ra, Seung Won
Oh, Yeon Mok
Choi, Hayoung
Lee, Hyun
author_facet Yoon, Jai Hoon
Kim, Sang Hyuk
Ryu, Jiin
Chung, Sung Jun
Kim, Youlim
Yoon, Chang Ki
Ra, Seung Won
Oh, Yeon Mok
Choi, Hayoung
Lee, Hyun
author_sort Yoon, Jai Hoon
collection PubMed
description BACKGROUND: Gastro-oesophageal reflux disease (GORD) is not only a common aetiology but also accompanying comorbidity of non-cystic fibrosis bronchiectasis (bronchiectasis). However, the association between GORD and the disease burden of bronchiectasis has not been well evaluated. Our study aimed to evaluate whether GORD is associated with increased healthcare use and medical costs in patients with bronchiectasis. METHODS: We analyzed the data from 44,119 patients with bronchiectasis using a large representative Korean population-based claim database between 2009 and 2017. We compared the healthcare use [outpatient department (OPD) visits and emergency room (ER) visits/hospitalizations] and medical costs in patients with bronchiectasis according to the presence or absence of GORD. RESULTS: The prevalence of GORD in patients with bronchiectasis tended to increase during the study period, especially in the 50s and older population. GORD was associated with increased use of all investigated healthcare resources in patients with bronchiectasis. Healthcare use including OPD visits (mean 47.6/person/year versus 30.0/person/year), ER visits/hospitalizations (mean 1.7/person/year versus 1.1/person/year), and medical costs (mean 3564.5 Euro/person/year versus 2198.7 Euro/person/year) were significantly higher in bronchiectasis patients with GORD than in those without GORD (p < 0.001 for all). In multivariable analysis, bronchiectasis patients with GORD showed 1.44-fold (95% confidence interval = 1.37–1.50) and 1.26-fold (95% confidence interval = 1.19–1.33) increased all-cause and respiratory-related ER visits/hospitalizations relative to those without GORD, respectively. After adjusting for potential confounders, the estimated total medical costs (mean 4337.3 versus 3397.4 Euro/person/year) and respiratory disease-related medical costs (mean 920.7 versus 720.2 Euro/person/year) were significantly higher in bronchiectasis patients with GORD than in those without GORD (p < 0.001 for both). CONCLUSION: In patients with bronchiectasis, GORD was associated with increased healthcare use and medical costs. Strategies to reduce the disease burden associated with GORD are needed in patients with bronchiectasis.
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spelling pubmed-87213802022-01-04 Gastro-oesophageal reflux disease increases healthcare use and medical costs in patients with bronchiectasis: a Korean nationwide population-based study Yoon, Jai Hoon Kim, Sang Hyuk Ryu, Jiin Chung, Sung Jun Kim, Youlim Yoon, Chang Ki Ra, Seung Won Oh, Yeon Mok Choi, Hayoung Lee, Hyun Therap Adv Gastroenterol Original Research BACKGROUND: Gastro-oesophageal reflux disease (GORD) is not only a common aetiology but also accompanying comorbidity of non-cystic fibrosis bronchiectasis (bronchiectasis). However, the association between GORD and the disease burden of bronchiectasis has not been well evaluated. Our study aimed to evaluate whether GORD is associated with increased healthcare use and medical costs in patients with bronchiectasis. METHODS: We analyzed the data from 44,119 patients with bronchiectasis using a large representative Korean population-based claim database between 2009 and 2017. We compared the healthcare use [outpatient department (OPD) visits and emergency room (ER) visits/hospitalizations] and medical costs in patients with bronchiectasis according to the presence or absence of GORD. RESULTS: The prevalence of GORD in patients with bronchiectasis tended to increase during the study period, especially in the 50s and older population. GORD was associated with increased use of all investigated healthcare resources in patients with bronchiectasis. Healthcare use including OPD visits (mean 47.6/person/year versus 30.0/person/year), ER visits/hospitalizations (mean 1.7/person/year versus 1.1/person/year), and medical costs (mean 3564.5 Euro/person/year versus 2198.7 Euro/person/year) were significantly higher in bronchiectasis patients with GORD than in those without GORD (p < 0.001 for all). In multivariable analysis, bronchiectasis patients with GORD showed 1.44-fold (95% confidence interval = 1.37–1.50) and 1.26-fold (95% confidence interval = 1.19–1.33) increased all-cause and respiratory-related ER visits/hospitalizations relative to those without GORD, respectively. After adjusting for potential confounders, the estimated total medical costs (mean 4337.3 versus 3397.4 Euro/person/year) and respiratory disease-related medical costs (mean 920.7 versus 720.2 Euro/person/year) were significantly higher in bronchiectasis patients with GORD than in those without GORD (p < 0.001 for both). CONCLUSION: In patients with bronchiectasis, GORD was associated with increased healthcare use and medical costs. Strategies to reduce the disease burden associated with GORD are needed in patients with bronchiectasis. SAGE Publications 2021-12-21 /pmc/articles/PMC8721380/ /pubmed/34987606 http://dx.doi.org/10.1177/17562848211062801 Text en © The Author(s), 2021 https://creativecommons.org/licenses/by-nc/4.0/This article is distributed under the terms of the Creative Commons Attribution-NonCommercial 4.0 License (https://creativecommons.org/licenses/by-nc/4.0/) which permits non-commercial use, reproduction and distribution of the work without further permission provided the original work is attributed as specified on the SAGE and Open Access pages (https://us.sagepub.com/en-us/nam/open-access-at-sage).
spellingShingle Original Research
Yoon, Jai Hoon
Kim, Sang Hyuk
Ryu, Jiin
Chung, Sung Jun
Kim, Youlim
Yoon, Chang Ki
Ra, Seung Won
Oh, Yeon Mok
Choi, Hayoung
Lee, Hyun
Gastro-oesophageal reflux disease increases healthcare use and medical costs in patients with bronchiectasis: a Korean nationwide population-based study
title Gastro-oesophageal reflux disease increases healthcare use and medical costs in patients with bronchiectasis: a Korean nationwide population-based study
title_full Gastro-oesophageal reflux disease increases healthcare use and medical costs in patients with bronchiectasis: a Korean nationwide population-based study
title_fullStr Gastro-oesophageal reflux disease increases healthcare use and medical costs in patients with bronchiectasis: a Korean nationwide population-based study
title_full_unstemmed Gastro-oesophageal reflux disease increases healthcare use and medical costs in patients with bronchiectasis: a Korean nationwide population-based study
title_short Gastro-oesophageal reflux disease increases healthcare use and medical costs in patients with bronchiectasis: a Korean nationwide population-based study
title_sort gastro-oesophageal reflux disease increases healthcare use and medical costs in patients with bronchiectasis: a korean nationwide population-based study
topic Original Research
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8721380/
https://www.ncbi.nlm.nih.gov/pubmed/34987606
http://dx.doi.org/10.1177/17562848211062801
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