Читать книгу The Esophagus - Группа авторов - Страница 29

Esophageal disease is a significant source of symptoms for patients worldwide, and as a result, its impact on the health care system and quality of life (QoL) is significant. In one study of almost 72,000 patients who reported experiencing at least one GI symptom within the previous week, nearly one‐third experienced heartburn or regurgitation [47]. In the United States in 2015, health care expenditures for gastrointestinal diseases totaled $135.9 billion, and esophageal disease was the second most expensive category ($18.1 billion). Prescription medications accounted for 54% of the total expenditures for esophageal disorders, and from 2011 to 2015, approximately $60 billion was spent on acid‐suppressing medications. In 2014, GERD was the second‐leading gastrointestinal disease diagnosed by physicians in the ambulatory care setting [48].

GERD symptoms also have been shown to have a significant impact on workplace productivity. One retrospective case‐control analysis of employee health care and payroll data in the United States showed that employees with GERD had 41% more sick leave days, 4.4% lower objective productivity per hour, and 6% lower annual objective productivity [49]. This was shown in an additional US study in which 41% of GERD patients reported lost work productivity due to their disease, with the calculated average loss per GERD patient equaling $237 over a three‐month period. A major cited reason was needed time off for physician visits [50]. Similar findings have also been seen in other US [51, 52] and European studies. One German study estimated that the loss of gross domestic product due to GERD symptoms amounted to 668 million euros/year [53]. The average sick leave time attributable to reflux was 1.4 workdays in a three‐month span [54].