Division of Gastroenterology and Hepatology, Mayo Clinic, Rochester, MN, USA.
J Pediatr Gastroenterol Nutr. 2011 Jan;52(1):47-54. doi: 10.1097/MPG.0b013e3181e67058.
Although direct medical costs for constipation-related medical visits are thought to be high, to date there have been no studies examining whether longitudinal resource use is persistently elevated in children with constipation. Our aim was to estimate the incremental direct medical costs and types of health care use associated with constipation from childhood to early adulthood.
A nested case-control study was conducted to evaluate the incremental costs associated with constipation. The original sample consisted of 5718 children in a population-based birth cohort who were born during 1976 to 1982 in Rochester, MN. The cases included individuals who presented to medical facilities with constipation. The controls were matched and randomly selected among all noncases in the sample. Direct medical costs for cases and controls were collected from the time subjects were between 5 and 18 years of age or until the subject emigrated from the community.
We identified 250 cases with a diagnosis of constipation in the birth cohort. Although the mean inpatient costs for cases were $9994 (95% Confidence interval [CI] 2538-37,201) compared with $2391 (95% CI 923-7452) for controls (P = 0.22) during the time period, the mean outpatient costs for cases were $13,927 (95% CI 11,325-16,525) compared with $3448 (95% CI 3771-4621) for controls (P < 0.001) during the same time period. The mean annual number of emergency department visits for cases was 0.66 (95% CI 0.62-0.70) compared with 0.34 (95% CI 0.32-0.35) for controls (P < 0.0001).
Individuals with constipation have higher medical care use. Outpatient costs and emergency department use were significantly greater for individuals with constipation from childhood to early adulthood.
尽管人们认为与便秘相关的医疗就诊的直接医疗费用较高，但迄今为止，尚无研究检查便秘儿童的纵向资源利用是否持续升高。我们的目的是评估从儿童期到成年早期与便秘相关的增量直接医疗成本和医疗保健使用类型。
进行了一项嵌套病例对照研究，以评估与便秘相关的增量成本。原始样本包括明尼苏达州罗彻斯特市 1976 年至 1982 年期间出生的一项基于人群的出生队列中的 5718 名儿童。病例包括在医疗设施就诊的便秘患者。对照组是从样本中的所有非病例中随机选择并匹配的。病例和对照组的直接医疗费用从研究对象 5 至 18 岁或从社区移民时开始收集。
我们在出生队列中确定了 250 例便秘诊断病例。尽管病例的平均住院费用为 9994 美元（95%置信区间[CI] 2538-37201），而对照组为 2391 美元（95%CI 923-7452）（P = 0.22），但病例的平均门诊费用为 13927 美元（95%CI 11325-16525），而对照组为 3448 美元（95%CI 3771-4621）（P <0.001）。病例的平均年急诊就诊次数为 0.66（95%CI 0.62-0.70），而对照组为 0.34（95%CI 0.32-0.35）（P <0.0001）。
便秘患者的医疗保健利用率更高。从儿童期到成年早期，便秘患者的门诊费用和急诊就诊次数明显更高。
