United States Healthcare Burden of Pediatric Functional Gastrointestinal Pain Disorder Hospitalizations from 2002 to
John M Hollier1,2, Jason L Salemi3,4, Robert J Shulman1,2,5
1Division of Gastroenterology, Hepatology, and Nutrition, Department of Pediatrics, Baylor College of Medicine, Houston, Texas, USA.
Insights
Pediatric functional gastrointestinal disorder hospitalizations decreased recently, but constipation admissions rose. Costs increased due to procedures, highlighting a need for further research into these trends.
Area of Science:
- Pediatric Gastroenterology
- Health Services Research
- Epidemiology
Background:
- The healthcare burden of pediatric functional gastrointestinal pain disorders (FGIDs) in the US remains poorly understood.
- Characterizing the hospitalization burden is crucial for resource allocation and patient care.
Purpose of the Study:
- To analyze the trends in prevalence, length of stay, and costs of pediatric FGID hospitalizations in the United States from 2002 to 2018.
- To identify demographic disparities and common interventions associated with these hospitalizations.
Main Methods:
- Utilized the US National Inpatient Sample (NIS) data from 2002-2018.
- Included pediatric hospitalizations (ages 4-18) with primary FGID diagnoses.
- Analyzed prevalence rates, length of stay (LOS), inflation-adjusted costs, and intervention trends using joinpoint analyses.
Main Results:
- 1 in 64 pediatric hospitalizations were for FGIDs, with overall prevalence decreasing from 2013-2018.
- Constipation admissions increased significantly, particularly among younger non-Hispanic Blacks and Hispanics.
- Average LOS stabilized recently, but costs per hospitalization increased, driven by endoscopic procedures.
Conclusions:
- Recent decreases in FGID hospitalization rates may reflect healthcare policy changes.
- Rising constipation admissions and increasing costs necessitate further investigation.
- Endoscopic procedures are a significant cost driver, warranting closer examination.
Background:
The healthcare burden of pediatric functional gastrointestinal pain disorders (FGIDs) is unclear. Our study aimed to characterize the burden of these hospitalizations in the United States (US).
Methods:
We utilized the US National Inpatient Sample from 2002 to 2018 to capture pediatric hospitalizations (ages 4 to 18 years old) with a primary discharge diagnosis of abdominal pain, constipation, irritable bowel syndrome, dyspepsia, abdominal migraine, cyclic vomiting syndrome, or fecal incontinence. We calculated the FGID hospitalization prevalence rate, length of stay (LOS), and inflation-adjusted costs annually and assessed for statistically significant trend changes using joinpoint analyses.
Key Results:
22.3 million pediatric hospitalizations were captured, and 1 in 64 pediatric hospitalizations were attributed to a primary FGID hospitalization. The overall FGID hospitalization prevalence rate initially remained stable but decreased significantly from 2013 to 2018. Constipation and abdominal pain hospitalization rates, respectively, increased and decreased significantly over time. Constipation hospitalizations were more prevalent for younger non-Hispanic Blacks and Hispanics. FGID hospitalization rates stratified by sex were similar. Mean LOS was 2.3 days; average LOS increased significantly from 2002 to 2013 and then stabilized. FGID hospitalization costs averaged $6,216 per admission and increased significantly for all FGIDs except dyspepsia. Endoscopic procedures were the most common interventions.
Conclusions & Inferences:
FGID hospitalization prevalence rates decreased recently, possibly due to national healthcare policy implementation. Nonetheless, constipation admissions increased. LOS was stable in recent years but associated costs-per-hospitalization were increasing over time, probably due to endoscopic procedures. More studies are needed to explain these prevalence and cost trends.
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