The Epidemiology, Diagnosis, and Cost of Dyspepsia and Helicobater pylori Gastritis: A Case-Control Analysis in the Southwestern United States
Background Dyspepsia is among the most common complaints evaluated by gastroenterologists, but there are few studies examining its current epidemiology, evaluation, and costs. We examined these issues in a large managed care system in the Southwestern United States. Methods We conducted a retrospect...
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| Veröffentlicht in: | Helicobacter (Cambridge, Mass.) Mass.), 2013-02, Vol.18 (1), p.54-65 |
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| creator | Mapel, Douglas Roberts, Melissa Overhiser, Andrew Mason, Andrew |
| description | Background
Dyspepsia is among the most common complaints evaluated by gastroenterologists, but there are few studies examining its current epidemiology, evaluation, and costs. We examined these issues in a large managed care system in the Southwestern United States.
Methods
We conducted a retrospective case–control analysis of adults with incident dyspepsia or a Helicobacter pylori‐related condition in years 2006 through 2010 using utilization data. Medical record ion of 400 cases was conducted to obtain additional clinical information.
Results
A total of 6989 cases met all inclusion and exclusion criteria. Women had a substantially higher risk of dyspepsia than men (14 per 1000 per year vs 10 per 1000; p |
| doi_str_mv | 10.1111/j.1523-5378.2012.00988.x |
| format | Article |
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Dyspepsia is among the most common complaints evaluated by gastroenterologists, but there are few studies examining its current epidemiology, evaluation, and costs. We examined these issues in a large managed care system in the Southwestern United States.
Methods
We conducted a retrospective case–control analysis of adults with incident dyspepsia or a Helicobacter pylori‐related condition in years 2006 through 2010 using utilization data. Medical record ion of 400 cases was conducted to obtain additional clinical information.
Results
A total of 6989 cases met all inclusion and exclusion criteria. Women had a substantially higher risk of dyspepsia than men (14 per 1000 per year vs 10 per 1000; p < .001), and the incidence of dyspepsia increased with age such that persons in their seventh decade had almost twice the risk of those aged 18–29. Hispanic persons had a significantly higher risk of dyspepsia and positive H. pylori testing. Dyspepsia cases had a higher prevalence of other chronic comorbidities than their matched controls. Dyspepsia patients had healthcare costs 54% higher than controls even before the diagnosis was made, and costs in the initial diagnostic period were $483 greater per person, but subsequent costs were not greatly affected. Among those aged 55 and younger, the “test and treat” approach was used in 53% and another 18% had an initial esophagogastroduodenoscopy, as compared to 47 and 27%, respectively, among those over the age of 55.
Conclusions
Women and older adults have a higher incidence of dyspepsia than previously appreciated, and Hispanics in this region also have a higher risk. Current guidelines for dyspepsia evaluation are only loosely followed.</description><identifier>ISSN: 1083-4389</identifier><identifier>EISSN: 1523-5378</identifier><identifier>DOI: 10.1111/j.1523-5378.2012.00988.x</identifier><identifier>PMID: 23067108</identifier><language>eng</language><publisher>Blackwell Publishing Ltd</publisher><subject>Age ; cost ; Data processing ; Dyspepsia ; Epidemiology ; evaluation ; Gastritis ; Helicobacter ; Helicobacter pylori ; medical records ; Original ; Risk factors</subject><ispartof>Helicobacter (Cambridge, Mass.), 2013-02, Vol.18 (1), p.54-65</ispartof><rights>2012 Blackwell Publishing Ltd</rights><rights>Copyright © 2013 Blackwell Publishing Ltd 2013</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://onlinelibrary.wiley.com/doi/pdf/10.1111%2Fj.1523-5378.2012.00988.x$$EPDF$$P50$$Gwiley$$Hfree_for_read</linktopdf><linktohtml>$$Uhttps://onlinelibrary.wiley.com/doi/full/10.1111%2Fj.1523-5378.2012.00988.x$$EHTML$$P50$$Gwiley$$Hfree_for_read</linktohtml><link.rule.ids>230,314,780,784,885,1416,27922,27923,45572,45573</link.rule.ids></links><search><creatorcontrib>Mapel, Douglas</creatorcontrib><creatorcontrib>Roberts, Melissa</creatorcontrib><creatorcontrib>Overhiser, Andrew</creatorcontrib><creatorcontrib>Mason, Andrew</creatorcontrib><title>The Epidemiology, Diagnosis, and Cost of Dyspepsia and Helicobater pylori Gastritis: A Case-Control Analysis in the Southwestern United States</title><title>Helicobacter (Cambridge, Mass.)</title><addtitle>Helicobacter</addtitle><description>Background
Dyspepsia is among the most common complaints evaluated by gastroenterologists, but there are few studies examining its current epidemiology, evaluation, and costs. We examined these issues in a large managed care system in the Southwestern United States.
Methods
We conducted a retrospective case–control analysis of adults with incident dyspepsia or a Helicobacter pylori‐related condition in years 2006 through 2010 using utilization data. Medical record ion of 400 cases was conducted to obtain additional clinical information.
Results
A total of 6989 cases met all inclusion and exclusion criteria. Women had a substantially higher risk of dyspepsia than men (14 per 1000 per year vs 10 per 1000; p < .001), and the incidence of dyspepsia increased with age such that persons in their seventh decade had almost twice the risk of those aged 18–29. Hispanic persons had a significantly higher risk of dyspepsia and positive H. pylori testing. Dyspepsia cases had a higher prevalence of other chronic comorbidities than their matched controls. Dyspepsia patients had healthcare costs 54% higher than controls even before the diagnosis was made, and costs in the initial diagnostic period were $483 greater per person, but subsequent costs were not greatly affected. Among those aged 55 and younger, the “test and treat” approach was used in 53% and another 18% had an initial esophagogastroduodenoscopy, as compared to 47 and 27%, respectively, among those over the age of 55.
Conclusions
Women and older adults have a higher incidence of dyspepsia than previously appreciated, and Hispanics in this region also have a higher risk. Current guidelines for dyspepsia evaluation are only loosely followed.</description><subject>Age</subject><subject>cost</subject><subject>Data processing</subject><subject>Dyspepsia</subject><subject>Epidemiology</subject><subject>evaluation</subject><subject>Gastritis</subject><subject>Helicobacter</subject><subject>Helicobacter pylori</subject><subject>medical records</subject><subject>Original</subject><subject>Risk factors</subject><issn>1083-4389</issn><issn>1523-5378</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2013</creationdate><recordtype>article</recordtype><sourceid>24P</sourceid><sourceid>WIN</sourceid><recordid>eNpVUdFu0zAUjRCIjcE_-JGHJVzHSewghFRlpUWqQGibJvFi2c1N6-LGIU5Z8xN8M846VcIvvvK55xzfe6KIUEhoOB92Cc1TFueMiyQFmiYApRDJ8UV0eQZehhoEizMmyovojfc7AMhZVr6OLlIGBQ_oZfT3botk3pka98ZZtxmvyY1Rm9Z546-JamtSOT8Q15Cb0XfYeaOeXpdozdppNWBPutG63pCF8kNvBuM_khmplMe4cu3QO0tmrbJjECSmJUPwu3WHYfuIPpBbct-aAWtyOwQt_zZ61Sjr8d3zfRXdf5nfVct49X3xtZqtYsNEJmLOszAAFoXOOKMITZMDLzAFpVNKta6VzksQBW-wVFqAThFQNErXbB3WBewq-nzS7Q56j_Uaw0eVlV1v9qofpVNG_o-0Zis37o9kBUzeQeD9s0Dvfh_CKHJv_BqtVS26g5c0FTmUvCzy0Prp1PpoLI5nDwpyylLu5BSZnCKTU5byKUt5lMv5KhSBHp_oJuzreKar_pcsOOO5fPi2kGzBlj_hRyYf2D8bD6UF</recordid><startdate>201302</startdate><enddate>201302</enddate><creator>Mapel, Douglas</creator><creator>Roberts, Melissa</creator><creator>Overhiser, Andrew</creator><creator>Mason, Andrew</creator><general>Blackwell Publishing Ltd</general><scope>BSCLL</scope><scope>24P</scope><scope>WIN</scope><scope>7QL</scope><scope>C1K</scope><scope>5PM</scope></search><sort><creationdate>201302</creationdate><title>The Epidemiology, Diagnosis, and Cost of Dyspepsia and Helicobater pylori Gastritis: A Case-Control Analysis in the Southwestern United States</title><author>Mapel, Douglas ; Roberts, Melissa ; Overhiser, Andrew ; Mason, Andrew</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-i3848-774067e66b4731e0ff5076e20ab211bbdab590867fe9ab80b2e0e8fabd3c01203</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2013</creationdate><topic>Age</topic><topic>cost</topic><topic>Data processing</topic><topic>Dyspepsia</topic><topic>Epidemiology</topic><topic>evaluation</topic><topic>Gastritis</topic><topic>Helicobacter</topic><topic>Helicobacter pylori</topic><topic>medical records</topic><topic>Original</topic><topic>Risk factors</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Mapel, Douglas</creatorcontrib><creatorcontrib>Roberts, Melissa</creatorcontrib><creatorcontrib>Overhiser, Andrew</creatorcontrib><creatorcontrib>Mason, Andrew</creatorcontrib><collection>Istex</collection><collection>Wiley-Blackwell Open Access Titles</collection><collection>Wiley Free Content</collection><collection>Bacteriology Abstracts (Microbiology B)</collection><collection>Environmental Sciences and Pollution Management</collection><collection>PubMed Central (Full Participant titles)</collection><jtitle>Helicobacter (Cambridge, Mass.)</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Mapel, Douglas</au><au>Roberts, Melissa</au><au>Overhiser, Andrew</au><au>Mason, Andrew</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>The Epidemiology, Diagnosis, and Cost of Dyspepsia and Helicobater pylori Gastritis: A Case-Control Analysis in the Southwestern United States</atitle><jtitle>Helicobacter (Cambridge, Mass.)</jtitle><addtitle>Helicobacter</addtitle><date>2013-02</date><risdate>2013</risdate><volume>18</volume><issue>1</issue><spage>54</spage><epage>65</epage><pages>54-65</pages><issn>1083-4389</issn><eissn>1523-5378</eissn><abstract>Background
Dyspepsia is among the most common complaints evaluated by gastroenterologists, but there are few studies examining its current epidemiology, evaluation, and costs. We examined these issues in a large managed care system in the Southwestern United States.
Methods
We conducted a retrospective case–control analysis of adults with incident dyspepsia or a Helicobacter pylori‐related condition in years 2006 through 2010 using utilization data. Medical record ion of 400 cases was conducted to obtain additional clinical information.
Results
A total of 6989 cases met all inclusion and exclusion criteria. Women had a substantially higher risk of dyspepsia than men (14 per 1000 per year vs 10 per 1000; p < .001), and the incidence of dyspepsia increased with age such that persons in their seventh decade had almost twice the risk of those aged 18–29. Hispanic persons had a significantly higher risk of dyspepsia and positive H. pylori testing. Dyspepsia cases had a higher prevalence of other chronic comorbidities than their matched controls. Dyspepsia patients had healthcare costs 54% higher than controls even before the diagnosis was made, and costs in the initial diagnostic period were $483 greater per person, but subsequent costs were not greatly affected. Among those aged 55 and younger, the “test and treat” approach was used in 53% and another 18% had an initial esophagogastroduodenoscopy, as compared to 47 and 27%, respectively, among those over the age of 55.
Conclusions
Women and older adults have a higher incidence of dyspepsia than previously appreciated, and Hispanics in this region also have a higher risk. Current guidelines for dyspepsia evaluation are only loosely followed.</abstract><pub>Blackwell Publishing Ltd</pub><pmid>23067108</pmid><doi>10.1111/j.1523-5378.2012.00988.x</doi><tpages>12</tpages><oa>free_for_read</oa></addata></record> |
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| ispartof | Helicobacter (Cambridge, Mass.), 2013-02, Vol.18 (1), p.54-65 |
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| language | eng |
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| source | Wiley Online Library All Journals |
| subjects | Age cost Data processing Dyspepsia Epidemiology evaluation Gastritis Helicobacter Helicobacter pylori medical records Original Risk factors |
| title | The Epidemiology, Diagnosis, and Cost of Dyspepsia and Helicobater pylori Gastritis: A Case-Control Analysis in the Southwestern United States |
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