US Pharm. 2013;38(12):60.
In 2010, 70 million people with digestive disorders made 104.7
million visits to healthcare providers in ambulatory care settings.
During these visits, 20 million patients underwent surgical diagnostic
and therapeutic procedures. In 2010, 285 million drugs were dispensed or
prescribed for stomach and abdominal pain during 74% of all outpatient
visits to nonfederal short-stay and general hospitals. Of the $141.8
billion expended on digestive disorders, 69% were direct costs.
Prescriptions: A total of 97.3 million prescriptions
were dispensed for gastrointestinal (GI) disorders. Gastroesophageal
reflux disease (GERD) was treated with five proton pump inhibitors
(PPIs) for 77.3% of the total cost and 66.4% of the total number of
prescriptions. Other costly drugs were mesalamine (inflammatory bowel
disease [IBD]), ranitidine, tegaserod (irritable bowel syndrome [IBS],
and constipation), and ribavirin and peginterferon alfa-2a (hepatitis
Prevalence: GI infections were the most
prevalent form of digestive disease (135 million patients, or 33%). Of
the remaining 67%, 87 million patients suffered from hemorrhoids, 63
million from chronic constipation, 62 million from GERD, 20 million from
gallstones, 15.3 million from IBS, and 15.5 million from peptic ulcer
disease (PUD). The least prevalent form of digestive disease was IBD
Ambulatory Care Visits: For every 100 patients,
35 ambulatory care visits were made for digestive disorders. More than
half of ambulatory care visits for GI infections occurred in patients
younger than 15 years. The rate of visits was 45.7% higher among white
than among black patients, and 18.1% higher among females than among
males. The rate of ambulatory care visits increased from 26.4 per 100
patients in 1992 to 35.3 per 100 patients in 2005. GERD patients made
the most visits (18.3 million) to ambulatory care settings, followed by
6.3 million visits by patients with chronic constipation.
Hospitalizations: There were 4.6 million
discharges of patients with digestive disease as the first-listed
diagnosis and 13.5 million discharges of those with digestive disease as
the all-listed diagnosis. Of the digestive disorders, GERD was the most
frequent reason for hospitalization (3.1 million; 34.4%), followed by
diverticular (9%) and liver disease (8.4%). The proportion of
hospitalizations was fairly equal (5%) for PUD, pancreatitis, and GI
infections, and hospitalization due to IBD and IBS was least frequent
(2.4%). The number of discharges from hospital inpatient care for
chronic liver disease and cirrhosis was 101,000, but the rate of deaths
attributed to these disorders was 10.3 per 100,000 patients.
Mortality: Of all digestive disorders, liver
disease was the most common cause of death (59.5%), followed by viral
hepatitis C (7.6%) and GI infections (7.3%).
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