학술논문

Association of diagnostic delay with medical cost for patients with Crohn's disease: A Japanese claims‐based cohort study
Document Type
article
Source
JGH Open, Vol 5, Iss 5, Pp 568-572 (2021)
Subject
anti‐tumor necrosis factor alpha
Crohn's disease
diagnostic delay
medical cost
Diseases of the digestive system. Gastroenterology
RC799-869
Language
English
ISSN
2397-9070
Abstract
Abstract Background and Aim Longer diagnostic delay (DD) in Crohn's disease (CD) is associated with complications and related surgeries. However, the impact of DD on medical cost after CD diagnosis remains uncertain. Methods This was a claims‐based cohort study. Our analysis used data from 2005 to 2018 from the Japanese Claims Database. We enrolled a total of 528 newly diagnosed CD patients (76.9% male) aged 31.5 ± 13.6 years. High medical cost was defined as the highest quartile of the average monthly medical cost. DD was defined as the interval between the first visit to a gastroenterologist and diagnosis with CD. In the multivariable logistic regression analysis, patients were stratified by the use of anti‐tumor necrosis factor alpha (anti‐TNFα) agents to exclude their influence on the observed effects. This study was approved by the ethics review board of the Juntendo University Faculty of Medicine (No. 2019178). Results The multivariable‐adjusted odds ratios and 95% confidence intervals of high medical cost were 1.41 (0.81–2.43) and 0.91 (0.57–1.46), respectively, for a DD of >12 months and 1 to ≤12 months compared to 12 months and 1 to ≤12 months, respectively, compared to