Anal fistula is an abnormal tract with an external and internal opening that cause leakage, discomfort, and occasionally pain. Surgery is standard treatment, but recurrence and anal incontinence is common. This study estimated health care resource use, costs and sick leave for newly diagnosed patients with anal fistula in Sweden. The study is based on register data from linkages between Swedish population-based registers for patients treated for anal fistula in Västra Götaland County, Sweden. The sample included 362 patients of which 27% had no surgery, 37% had one surgery and 36% had multiple surgeries. Total discounted costs were €5561 per patient where approximately 80% were direct costs. The study indicates that anal fistula is a condition that is costly for society. The burden of anal fistula in terms of health care resources and sick leave is especially high for patients experiencing multiple surgeries and there is an unmet need for this group of patients to find appropriate treatment interventions.
International Journal of Surgery, 2016; 35: 129-133