Effects on delayed surgery in inflammatory bowel disease – a health economic analysis

Introduction Timing in surgery for inflammatory bowel disease (IBD) is important, considering risk of complications. This study aimed to compare healthcare resource utilization and costs of delayed elective surgery in patients with IBD. Method This is a descriptive and observational study based on retrospectively collected data from Swedish national and regional registries. Patients either waiting for, or who had undergone, elective surgery at Sahlgrenska University Hospital during 2017-2023 with an IBD-diagnosis were identified. Result In total, 189 individuals were included, 40 controls (mean age 43.6 years, 18 women) who had surgery within 3 months, and 149 cases (mean age 41.6 years, 46 women), who had been waiting for surgery for at least 6 months. After 24-36 months the cost for the controls was 5470 EUR and for the cases 8510 EUR. Mean household yearly income was 36 027 EUR (CI 27 310–44 743) for the controls and 28 688 EUR (CI 25 844–31 532) for the cases. In total, 90% (n=36) were born in Sweden in the control group vs. 75.2% (n=112) in the case group. There was no difference in terms of sick leaves between the groups. Discussion Health care costs for patients with IBD waiting for surgery are similar to those of patients who have had elective surgery within 3 months. Given the additional postoperative costs for patients waiting for surgery, the overall costs are higher for this group. A short period of time between surgical decision and surgical date is therefore advisable.