A register-based case-control study of health care utilization and costs in binge-eating disorder

Hunna J. Watson, Andreas Jangmo, Tosha Smith, Laura M. Thornton, Yvonne von Hausswolff-Juhlin, Manisha Madhoo, Claes Norring, Elisabeth Welch, Camilla Wiklund, Henrik Larsson, Cynthia M. Bulik

Research output: Contribution to journalArticle

2 Citations (Scopus)

Abstract

Objective: Capturing trends in healthcare utilization may help to improve efficiencies in the detection and diagnosis of illness, to plan service delivery, and to forecast future health expenditures. For binge-eating disorder (BED), issues include lengthy delays in detection and diagnosis, missed opportunities for recognition and treatment, and morbidity. The study objective was to compare healthcare utilization and expenditure in people with and without BED. Methods: A case-control design and nationwide registers were used. All individuals diagnosed with BED at eating disorder clinics in Sweden between 2005 and 2009 were included (N = 319, 97% female, M age = 22 years). Ten controls (N = 3190) were matched to each case on age-, sex-, and location of birth. Inpatient, hospital-based outpatient, and prescription medication utilization and expenditure were analyzed up to eight years before and four years after the index date (i.e., date of diagnosis of the BED case). Results: Cases had significantly higher inpatient, hospital-based outpatient, and prescription medication utilization and expenditure compared with controls many years prior to and after diagnosis of BED. Utilization and expenditure for controls was relatively stable over time, but for cases followed an inverted U-shape and peaked at the index year. Care for somatic conditions normalized after the index year, but care for psychiatric conditions remained significantly higher. Conclusion: Individuals with BED had substantially higher healthcare utilization and costs in the years prior to and after diagnosis of BED. Since previous research shows a delay in diagnosis, findings indicate clear opportunities for earlier detection and clinical management. Training of providers in detection, diagnosis, and management may help curtail morbidity. A reduction in healthcare utilization was observed after BED diagnosis. This suggests that earlier diagnosis and treatment could improve long-term health outcomes and reduce the economic burden associated with BED.

Original languageEnglish
Pages (from-to)47-53
Number of pages7
JournalJournal of Psychosomatic Research
Volume108
DOIs
Publication statusPublished - 1 May 2018

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Patient Acceptance of Health Care
Binge-Eating Disorder
Health Care Costs
Case-Control Studies
Health Expenditures
Delivery of Health Care
Prescriptions
Inpatients
Outpatients
Morbidity
Sweden
Psychiatry
Early Diagnosis
Economics
Parturition

Cite this

Watson, H. J., Jangmo, A., Smith, T., Thornton, L. M., von Hausswolff-Juhlin, Y., Madhoo, M., ... Bulik, C. M. (2018). A register-based case-control study of health care utilization and costs in binge-eating disorder. Journal of Psychosomatic Research, 108, 47-53. https://doi.org/10.1016/j.jpsychores.2018.02.011
Watson, Hunna J. ; Jangmo, Andreas ; Smith, Tosha ; Thornton, Laura M. ; von Hausswolff-Juhlin, Yvonne ; Madhoo, Manisha ; Norring, Claes ; Welch, Elisabeth ; Wiklund, Camilla ; Larsson, Henrik ; Bulik, Cynthia M. / A register-based case-control study of health care utilization and costs in binge-eating disorder. In: Journal of Psychosomatic Research. 2018 ; Vol. 108. pp. 47-53.
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abstract = "Objective: Capturing trends in healthcare utilization may help to improve efficiencies in the detection and diagnosis of illness, to plan service delivery, and to forecast future health expenditures. For binge-eating disorder (BED), issues include lengthy delays in detection and diagnosis, missed opportunities for recognition and treatment, and morbidity. The study objective was to compare healthcare utilization and expenditure in people with and without BED. Methods: A case-control design and nationwide registers were used. All individuals diagnosed with BED at eating disorder clinics in Sweden between 2005 and 2009 were included (N = 319, 97{\%} female, M age = 22 years). Ten controls (N = 3190) were matched to each case on age-, sex-, and location of birth. Inpatient, hospital-based outpatient, and prescription medication utilization and expenditure were analyzed up to eight years before and four years after the index date (i.e., date of diagnosis of the BED case). Results: Cases had significantly higher inpatient, hospital-based outpatient, and prescription medication utilization and expenditure compared with controls many years prior to and after diagnosis of BED. Utilization and expenditure for controls was relatively stable over time, but for cases followed an inverted U-shape and peaked at the index year. Care for somatic conditions normalized after the index year, but care for psychiatric conditions remained significantly higher. Conclusion: Individuals with BED had substantially higher healthcare utilization and costs in the years prior to and after diagnosis of BED. Since previous research shows a delay in diagnosis, findings indicate clear opportunities for earlier detection and clinical management. Training of providers in detection, diagnosis, and management may help curtail morbidity. A reduction in healthcare utilization was observed after BED diagnosis. This suggests that earlier diagnosis and treatment could improve long-term health outcomes and reduce the economic burden associated with BED.",
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Watson, HJ, Jangmo, A, Smith, T, Thornton, LM, von Hausswolff-Juhlin, Y, Madhoo, M, Norring, C, Welch, E, Wiklund, C, Larsson, H & Bulik, CM 2018, 'A register-based case-control study of health care utilization and costs in binge-eating disorder' Journal of Psychosomatic Research, vol. 108, pp. 47-53. https://doi.org/10.1016/j.jpsychores.2018.02.011

A register-based case-control study of health care utilization and costs in binge-eating disorder. / Watson, Hunna J.; Jangmo, Andreas; Smith, Tosha; Thornton, Laura M.; von Hausswolff-Juhlin, Yvonne; Madhoo, Manisha; Norring, Claes; Welch, Elisabeth; Wiklund, Camilla; Larsson, Henrik; Bulik, Cynthia M.

In: Journal of Psychosomatic Research, Vol. 108, 01.05.2018, p. 47-53.

Research output: Contribution to journalArticle

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T1 - A register-based case-control study of health care utilization and costs in binge-eating disorder

AU - Watson, Hunna J.

AU - Jangmo, Andreas

AU - Smith, Tosha

AU - Thornton, Laura M.

AU - von Hausswolff-Juhlin, Yvonne

AU - Madhoo, Manisha

AU - Norring, Claes

AU - Welch, Elisabeth

AU - Wiklund, Camilla

AU - Larsson, Henrik

AU - Bulik, Cynthia M.

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N2 - Objective: Capturing trends in healthcare utilization may help to improve efficiencies in the detection and diagnosis of illness, to plan service delivery, and to forecast future health expenditures. For binge-eating disorder (BED), issues include lengthy delays in detection and diagnosis, missed opportunities for recognition and treatment, and morbidity. The study objective was to compare healthcare utilization and expenditure in people with and without BED. Methods: A case-control design and nationwide registers were used. All individuals diagnosed with BED at eating disorder clinics in Sweden between 2005 and 2009 were included (N = 319, 97% female, M age = 22 years). Ten controls (N = 3190) were matched to each case on age-, sex-, and location of birth. Inpatient, hospital-based outpatient, and prescription medication utilization and expenditure were analyzed up to eight years before and four years after the index date (i.e., date of diagnosis of the BED case). Results: Cases had significantly higher inpatient, hospital-based outpatient, and prescription medication utilization and expenditure compared with controls many years prior to and after diagnosis of BED. Utilization and expenditure for controls was relatively stable over time, but for cases followed an inverted U-shape and peaked at the index year. Care for somatic conditions normalized after the index year, but care for psychiatric conditions remained significantly higher. Conclusion: Individuals with BED had substantially higher healthcare utilization and costs in the years prior to and after diagnosis of BED. Since previous research shows a delay in diagnosis, findings indicate clear opportunities for earlier detection and clinical management. Training of providers in detection, diagnosis, and management may help curtail morbidity. A reduction in healthcare utilization was observed after BED diagnosis. This suggests that earlier diagnosis and treatment could improve long-term health outcomes and reduce the economic burden associated with BED.

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