Healthcare costs and resource utilization of patients with binge-eating disorder and eating disorder not otherwise specified in the Department of Veterans Affairs

• Published in: The International journal of eating disorders 2015-12, Vol.48 (8), p.1082-1091
• Main Authors: Bellows, Brandon K., DuVall, Scott L., Kamauu, Aaron W.C., Supina, Dylan, Babcock, Thomas, LaFleur, Joanne
• Format: Article
• Language: English
• Subjects: Adult; Binge eating; binge-eating disorder; Binge-Eating Disorder - economics; Cohort Studies; Comparative analysis; eating disorder not otherwise specified; Eating disorders; Electronic Health Records; Feeding and Eating Disorders - economics; Female; Generalized linear models; Health Care Costs; Health care expenditures; healthcare costs; healthcare utilization; Humans; Male; Mental depression; Middle Aged; observational study; Patient Acceptance of Health Care - statistics & numerical data; United States; United States Department of Veterans Affairs - statistics & numerical data; Veterans; Veterans - statistics & numerical data
• ISSN: 0276-3478; 1098-108X
• DOI: 10.1002/eat.22427

ABSTRACT Objective The objective of this study was to compare the one‐year healthcare costs and utilization of patients with binge‐eating disorder (BED) to patients with eating disorder not otherwise specified without BED (EDNOS‐only) and to matched patients without an eating disorder (NED). Methods A natural language processing (NLP) algorithm identified adults with BED from clinical notes in the Department of Veterans Affairs (VA) electronic health record database from 2000 to 2011. Patients with EDNOS‐only were identified using ICD‐9 code (307.50) and those with NLP‐identified BED were excluded. First diagnosis date defined the index date for both groups. Patients with NED were randomly matched 4:1, as available, to patients with BED on age, sex, BMI, depression diagnosis, and index month. Patients with cost data (2005–2011) were included. Total healthcare, inpatient, outpatient, and pharmacy costs were examined. Generalized linear models were used to compare total one‐year healthcare costs while adjusting for baseline patient characteristics. Results There were 257 BED, 743 EDNOS‐only, and 823 matched NED patients identified. The mean (SD) total unadjusted one‐year costs, in 2011 US dollars, were $33,716 ($38,928) for BED, $37,052 ($40,719) for EDNOS‐only, and $19,548 ($35,780) for NED patients. When adjusting for patient characteristics, BED patients had one‐year total healthcare costs $5,589 higher than EDNOS‐only (p = 0.06) and $18,152 higher than matched NED patients (p