Ansari Humaira, Ansari Zahid, Lim Tracy, Hutson John M, Southwell Bridget R
Douglas Stephens Surgical Research Laboratory, Murdoch Childrens Research Institute, Parkville, Australia; Department of Paediatrics, University of Melbourne, Parkville, Australia.
J Paediatr Child Health. 2014 Dec;50(12):993-9. doi: 10.1111/jpc.12675. Epub 2014 Jun 27.
Constipation is common, with severe symptoms requiring hospitalisation. Constipation can be a primary (present at admission and requires treatment or investigation) or principal (first listed) diagnosis for hospitalisation. In the USA, constipation is the second most common ambulatory care digestive diagnosis with total costs >US$1.7 billion/year. Incidence of hospitalisation for constipation in children peaks at toilet-training age. This study determined the burden of paediatric constipation to hospital care in Victoria, Australia.
The Victorian Admitted Episodes Dataset was analysed retrospectively, examining hospital admissions with a primary diagnosis of constipation in the 7-year period 2002/2003 to 2008/2009.
For children, constipation was recorded as a primary diagnosis in 8688 admissions (3.6/1000 of population). In-hospital prevalence was ∼1.0%. Mean length of stay was 4.4 days (median 1.0, range 0-993, standard deviation 16.7). There were 1121 readmissions in 668 children. Average treatment cost was A$4235/admission (median A$1461, range A$0-$278 816), with annual costs of ∼A$5 505 500. Children in the highest socio-economic area had ∼50% fewer admissions (P < 0.0001). Predictors of readmission included age 10-18, male gender, rural residence, severe socio-economic disadvantage, public hospital, planned admission, longer length of stay and association with other medical conditions.
This study identified that constipation in children is a significant cost burden in Victoria (costing public hospitals ∼A$5.5 million/year). Hospitalisation in Victoria is 10-fold higher than in the USA with 10% readmissions within a month. We conclude that strategies aimed at reducing hospitalisation for constipation could result in significant savings for the paediatric public health system in Victoria, Australia.
便秘很常见，严重症状需要住院治疗。便秘可以是住院的主要诊断（入院时存在且需要治疗或检查）或首要诊断（首次列出）。在美国，便秘是门诊护理中第二常见的消化系统诊断，每年总成本超过17亿美元。儿童便秘住院率在如厕训练年龄达到峰值。本研究确定了澳大利亚维多利亚州儿科便秘对医院护理的负担。
对维多利亚州入院病例数据集进行回顾性分析，检查2002/2003年至2008/2009年7年间以便秘为主要诊断的住院情况。
儿童中，8688例住院病例记录便秘为主要诊断（每1000人中有3.6例）。住院患病率约为1.0%。平均住院时间为4.4天（中位数1.0天，范围0 - 993天，标准差16.7）。668名儿童中有1121例再次入院。平均治疗费用为每次住院4235澳元（中位数1461澳元，范围0 - 278816澳元），年费用约为5505500澳元。社会经济地位最高地区的儿童入院人数少约50%（P < 0.0001）。再次入院的预测因素包括年龄10 - 18岁、男性、农村居住、严重社会经济劣势、公立医院、计划入院、住院时间较长以及与其他疾病相关。
本研究发现儿童便秘在维多利亚州是一项重大成本负担（每年使公立医院花费约550万澳元）。维多利亚州的住院率比美国高10倍，且一个月内有10%的再次入院率。我们得出结论，旨在减少便秘住院率的策略可为澳大利亚维多利亚州的儿科公共卫生系统带来显著节省。
