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Cost evaluation of out-of-country care for patients with eating disorders in Ontario: a population-based study

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Background — Eating disorders, specifically anorexia nervosa, bulimia nervosa and eating disorder not otherwise specified, represent a substantial burden to the healthcare system. Our goal was to estimate the economic burden of patients who received specialized inpatient care for an eating disorder out of country.

Method — We conducted a cost-of-illness study evaluating healthcare costs among patients in Ontario who received specialized inpatient care for an eating disorder out of country from 2003 to 2011, from the public third-party payer perspective. Using linked administrative databases, we estimated net costs of eating disorders for 2 patient groups: those who received specialized inpatient care both out of country and in province (n = 160), and those who received specialized inpatient care out of country only (n = 126).

Results — Patients approved for specialized out-of-country inpatient care were mostly girls and young women from high-income, urban neighbourhoods. Total net costs varied annually and were higher for patients treated both out of country and in province (about $11 million before 2007, $6.5 million after) than for those treated out of country alone (about $5 million and $2 million, respectively). The main cost drivers were out-of-country care and physician services.

Interpretation — Costs associated with eating disorder care represent a substantial economic burden to the Ontario healthcare system. Given the high costs of out-of-country care, there may be opportunity to redirect these funds to increase capacity and expertise for eating disorder treatment within Ontario.

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Citation

de Oliveira C, Macdonald EM, Green D, Colton P, Olmsted M, Bondy S, Kurdyak P. CMAJ Open. 2016; 4(4):E661-7. Epub 2016 Nov 3.

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