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Interdisciplinary management of infantile short bowel syndrome: resource consumption, growth, and nutrition
Joanne F Olieman1, Marten J Poley, Saskia J Gischler
1Department of Pediatric Surgery, Erasmus MC-Sophia Children's Hospital, Erasmus MC, Rotterdam, The Netherlands. j.olieman@erasmusmc.nl
Insights
Treatment for infantile short bowel syndrome (SBS) is costly, primarily due to hospitalizations. Early home parenteral nutrition, facilitated by interdisciplinary teams, may reduce overall healthcare expenses for pediatric short bowel syndrome.
Area of Science:
- Pediatric Gastroenterology
- Health Economics
- Clinical Nutrition
Background:
- Infantile short bowel syndrome (SBS) lacks comprehensive treatment cost data.
- Growing emphasis on evidence-based and cost-effective pediatric medicine.
Purpose of the Study:
- To evaluate resource consumption and associated costs in infants with SBS.
- To assess nutritional and growth outcomes in pediatric SBS patients.
- To analyze costs beyond initial hospitalization for infantile short bowel syndrome.
Main Methods:
- Retrospective analysis of 10 infants diagnosed with SBS before age 1.
- Data collection on demographics, medical history, resource use, nutrition, and growth.
- Calculation of real economic costs in Euros and US Dollars.
Main Results:
- Average initial admission costs were €166,045 ($218,681), with total average costs reaching €269,700 ($355,195).
- Hospital admissions constituted the largest cost component (82%).
- Seven patients achieved full oral intake, and seven showed normal growth.
Conclusions:
- Infantile SBS treatment is resource-intensive, particularly for patients requiring parenteral nutrition.
- Early initiation of home parenteral nutrition can potentially reduce healthcare expenditures.
- Interdisciplinary teams play a crucial role in facilitating early home parenteral nutrition and managing costs.
Background/Purpose:
To date, there are hardly any data on the treatment costs of infantile short bowel syndrome (SBS), despite growing interest in evidence-based and cost-effective medicine. Therefore, the aim of the study was to evaluate resource consumption and costs, next to studying nutritional and growth outcomes, in children with SBS who were treated by an interdisciplinary short bowel team.
Methods:
Data were collected for 10 children with infantile SBS (
Results:
Seven of the 10 patients were discharged with home parenteral nutrition. Total follow-up varied between 9 months and 5.5 years (median, 1.5 years). Six patients could be weaned off parenteral nutrition and 5 patients off enteral tube feeding, resulting in full oral intake. Seven patients had normal growth. Median duration of initial hospital admission was 174 days, and average costs of initial admission amounted to euro166,045 ($218,681). Average total costs were euro269,700 ($355,195), reaching to a maximum of euro455,400 ($599,762). These costs mainly comprised hospital admissions (82%), followed by nutrition (12%), surgical interventions (5%), and outpatient visits (1%).
Conclusions:
This study is among the first to describe resource consumption and costs in infants with SBS, examining real economic costs and extending beyond the initial hospitalization. Treatment of SBS requires considerable resource consumption, especially when patients depend on parenteral nutrition. Because the costs mainly comprise those of hospital admissions, early home parenteral nutrition could contribute to costs reduction. Interdisciplinary teams have the potential to facilitate early home parenteral nutrition and thus may reduce health care costs.
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