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The economic burden of gastroschisis: costs of a birth defect
Diana M Hook-Dufresne1, Xiaoying Yu2, Vinay Bandla3
1Department of Pediatric Surgery, University of Texas Medical School at Houston, Houston, Texas.
Insights
Gastroschisis (GS) patients, though rare, incur significantly higher healthcare costs and longer hospital stays compared to other pediatric patients. Further research into intestinal dysfunction is needed to reduce the economic burden of this birth defect.
Area of Science:
- Pediatric Surgery
- Health Economics
- Neonatal Care
Background:
- Gastroschisis (GS) is an abdominal wall defect associated with intestinal dysfunction and feeding intolerance.
- These comorbidities lead to prolonged hospitalizations for affected infants.
- The economic impact of gastroschisis requires comprehensive evaluation.
Purpose of the Study:
- To assess the economic burden of gastroschisis on a national and state level.
- To quantify the impact of gastroschisis on hospital length of stay, costs, and charges.
Main Methods:
- Utilized the Healthcare Cost and Utilization Project database (2007-2011).
- Analyzed pediatric hospital discharge data for infants under 1 year old, including those with gastroschisis repair (CPT code 54.71).
- Calculated the combined estimated difference (CED) for length of stay, costs, and charges.
Main Results:
- Gastroschisis patients constituted only 0.04% of national pediatric discharges.
- Nationally, GS patients experienced significantly longer lengths of stay (CED 38.5 days), increased costs (CED $79,733), and higher charges (CED $249,999).
- Texas state data corroborated national findings, with no significant difference in outcomes between state and national levels.
Conclusions:
- Infants with gastroschisis represent a small fraction of pediatric discharges but incur disproportionately high healthcare utilization.
- Intestinal dysfunction significantly contributes to the prolonged hospital stay and elevated costs in gastroschisis patients.
- Further research into the factors driving intestinal dysfunction is crucial for mitigating the economic impact of gastroschisis.
Background:
Intestinal dysfunction and feeding intolerance are comorbidities associated with the abdominal wall birth defect of gastroschisis (GS). These factors contribute to prolonged hospitalization in this population of patients. The purpose of this study was to evaluate the economic burden on a state and national level.
Methods:
From 2007-2011, the Healthcare Cost and Utilization Project database was queried for the following national and state of Texas data: number of discharges, length of stay (LOS), costs, and charges for all pediatric hospital stays ± CPT code 54.71 denoting GS repair for infants aged <1 y. The effect of GS on LOS, cost, and charges was calculated by the weighted average of the differences and is represented by the combined estimated difference (CED).
Results:
Infants <1 y represent 74% of all pediatric discharges nationally and only 0.04% of these discharges are accounted for by GS patients. Nationally, GS patients had significantly longer LOS (CED 38.5 ± 0.9 d, P < 0.0001); increased costs (CED $79,733 ± $2119, P < 0.0001); and charges (CED $249,999 ± $9562, P < 0.0001). The Texas state data mirrored our findings for the national data. There was no significant difference in the LOS, costs, and charges between the national and state level.
Conclusions:
Our study shows that GS patients represent an extremely small minority of national and Texas pediatric discharges; however, these patients LOS and costs greatly exceed non-GS patients. Further investigation into factors influencing the development of intestinal dysfunction in these patients is needed to significantly impact the economic burden of the abdominal wall birth defect of GS.
