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Economic Impact and Prognostic Factors of Functional Dyspepsia in Children
Jyoti Mani1, Shailender Madani, Ron Thomas
1Department of Pediatrics, Children's Hospital of Michigan; Wayne State University, Detroit, MI.
Insights
Functional dyspepsia (FD) in children significantly impacts healthcare costs, with higher expenses for those with partial or no symptom improvement. This study estimated the economic burden and explored prognostic factors for pediatric FD.
Area of Science:
- Pediatric Gastroenterology
- Health Economics
Background:
- Functional dyspepsia (FD) is a common functional abdominal pain disorder in children.
- Limited data exists on the economic impact of FD in pediatric populations.
Purpose of the Study:
- To estimate the annual evaluation costs associated with diagnosing and managing FD in children.
- To identify potential prognostic factors influencing treatment outcomes in pediatric FD.
Main Methods:
- Retrospective analysis of 86 pediatric FD patients, divided into complete improvement (CIG) and partial/no improvement (PIG/NIG) groups.
- Annual evaluation costs were calculated using 2017 Medicare reimbursement rates.
- Prognostic factors and healthcare resource utilization (clinic visits, imaging, procedures) were compared between groups.
Main Results:
- The extrapolated annual evaluation cost for pediatric FD is approximately $5.79 billion.
- Patients in the PIG/NIG group incurred significantly higher evaluation costs ($904.95 ± $79.08) compared to the CIG group ($544.80 ± $87.99).
- Higher healthcare utilization, including clinic visits, imaging, and endoscopic procedures, was observed in the PIG/NIG group. No prognostic factors were identified.
Conclusions:
- Pediatric FD represents a substantial economic burden on healthcare systems.
- Incomplete treatment response in pediatric FD patients is associated with increased financial costs.
Objectives:
Functional dyspepsia (FD) is a functional abdominal pain disorder. There is paucity of data on the economic impact of FD in children. Primary aim of our study was to estimate annual evaluation cost ("diagnosis and visit" cost) and secondary aim was to identify potential prognostic factors of FD in children.
Methods:
Out of the 136 patients 86 met inclusion criteria and were divided into 2 clinical groups: Complete Improvement Group (CIG-30 patients) and Partial/No Improvement Group (PIG/NIG-56 patients). Medications used were noted descriptively. Annual evaluation cost was calculated using 2017 Medicare reimbursement rates.
Results:
Annual evaluation cost in all patients was $724.874 ± $180.075 ($544.799 ± $87.995 in CIG and $904.949 ± 79.083 in PIG/NIG). An extrapolated annual cost of evaluation in children with FD would be approximately $5.79 billion. Average number of clinic visits (3.1 ± 1.2 in CIG vs 4.40 ± 3.1 in PIG/NIG), duration of follow-up in months (9.2 ± 6.6 in CIG vs 17.1 ± 13.6 in PIG/NIG), use of imaging studies (7 patients in CIG [23.3%] vs 29 in PIG/NIG [51.8%]) and endoscopic procedures (17 in CIG [56.7%] vs 46 in PIG/NIG [82.1%]) were significantly higher in PIG/NIG (P < 0.005). PIG/NIG required multiple medications for control of symptoms compared to CIG (4 patients in CIG [13.5%] vs 30 in PIG [53.6%], P value <0.001]. For every $500.00 decrease in total evaluation cost the odds of having a complete response was 0.998 (P = 0.027). No prognostic factors were identified in children with FD.
Conclusions:
FD in children has a significant economic impact on health care expenditure. Patients with FD who have partial/no response to treatment incur greater financial cost potentially adding to health care expenditure.
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