Special ArticleBurden and Cost of Gastrointestinal, Liver, and Pancreatic Diseases in the United States: Update 2018
Section snippets
Symptoms and Diagnoses Across Ambulatory Settings
We used the 2014 National Ambulatory Medical Care Survey (NAMCS) to tabulate the leading GI symptoms and diagnoses in the United States for office-based outpatient visits. We used the National Hospital Ambulatory Medical Care Survey (NHAMCS) for ED visits for 2014. NHAMCS collects data on the utilization of ambulatory care services in hospital EDs regardless of outcome (ie, discharge from the ED, hospital admission, transfer, or death). NAMCS and NHAMCS are annual national surveys sponsored by
Symptoms and Diagnoses Across Ambulatory Settings
Using weighted national data, in 2014 there were more than 40.7 million ambulatory visits in the United States for GI symptoms (Table 1) and 54.4 million ambulatory visits with a primary diagnosis code for a GI disease (Table 2). The symptom of abdominal pain was responsible for more than 21.8 million total visits, followed by vomiting (4.7 million visits) and diarrhea (3.4 million visits) (Table 1). Abdominal pain was also the most frequent diagnosis (Table 2), with 16.5 million annual visits.
Discussion
The impact of GI diseases on patients and the health care system in the United States is substantial. Annual health care expenditures for these diseases total $135.9 billion. This is more than expenditures for heart disease ($113.4 billion), trauma-related disorders ($102.7 billion), and mental disorders ($98.8 billion).12 There are more than 40.7 million ambulatory visits for GI symptoms and 54.4 million visits with a primary diagnosis for a GI disease each year. There are more than 3.0
Acknowledgments
Author contributions: AFP, SDC, CCM, JLL, ESD, JLW, ETJ, NJS, ASB, SRL, BK, ELB, YCF, VP, JG, THB, RSS: data collection, data analysis, conception and study design, interpretation of data, manuscript preparation.
References (45)
- et al.
Burden of gastrointestinal, liver, and pancreatic diseases in the United States
Gastroenterology
(2015) - et al.
Burden of digestive diseases in the United States Part III: liver, biliary tract, and pancreas
Gastroenterology
(2009) - et al.
Burden of digestive diseases in the United States part II: lower gastrointestinal diseases
Gastroenterology
(2009) - et al.
Burden of digestive diseases in the United States part I: overall and upper gastrointestinal diseases
Gastroenterology
(2009) - et al.
Trends in burden of cirrhosis and hepatocellular carcinoma by underlying liver disease in US veterans, 2001-2013
Gastroenterology
(2015) - et al.
Individual state hepatitis C data supports expanding screening beyond baby boomers to all adults
Gastroenterology
(2018) - et al.
Direct-acting antiviral agents for patients with hepatitis C virus genotype 1 infection are cost-saving
Clin Gastroenterol Hepatol
(2017) - et al.
Increasing prevalence of hepatitis C among hospitalized children is associated with an increase in substance abuse
J Pediatr
(2018) - et al.
Decrease in incidence of colorectal cancer among individuals 50 years or older after recommendations for population-based screening
Clin Gastroenterol Hepatol
(2017) - et al.
The future of endoscopic retrograde cholangiopancreatography
Gastroenterology
(2017)
Evolution in the utilization of biliary interventions in the United States: results of a nationwide longitudinal study from 1998 to 2013
Gastrointest Endosc
How many endoscopies are performed for colorectal cancer screening? Results from CDC's survey of endoscopic capacity
Gastroenterology
Impact of the 2008-2009 economic recession on screening colonoscopy utilization among the insured
Clin Gastroenterol Hepatol
Polyp detection at colonoscopy: Endoscopist and technical factors
Best Pract Res Clin Gastroenterol
Applying a natural language processing tool to electronic health records to assess performance on colonoscopy quality measures
Gastrointest Endosc
Low rates of gastrointestinal and non-gastrointestinal complications for screening or surveillance colonoscopies in a population-based study
Gastroenterology
Increased rate of adenoma detection associates with reduced risk of colorectal cancer and death
Gastroenterology
Race, ethnicity, and sex affect risk for polyps >9 mm in average-risk individuals
Gastroenterology
Adenoma prevalence in blacks and whites having equal adherence to screening colonoscopy: the National Colonoscopy Study
Clin Gastroenterol Hepatol
Variation of adenoma prevalence by age, sex, race, and colon location in a large population: implications for screening and quality programs
Clin Gastroenterol Hepatol
Clinical and economic burden of emergency department visits due to gastrointestinal diseases in the United States
Am J Gastroenterol
The prevalence of hepatitis C virus infection in the United States, 1999 through 2002
Ann Intern Med
Cited by (0)
Conflicts of interest The authors disclose no conflicts.
Funding This research was supported in part by grants from the National Institutes of Health, K23DK113225, KL2TR001109, KL2TR001103, and T32 DK07634.