Conflict of interest: The authors have no conflict of interest.
Factors relating to hospitalisation and economic burden of paediatric constipation in the state of Victoria, Australia, 2002–2009
Article first published online: 27 JUN 2014
© 2014 The Authors. Journal of Paediatrics and Child Health © 2014 Paediatrics and Child Health Division (Royal Australasian College of Physicians)
Journal of Paediatrics and Child Health
Volume 50, Issue 12, pages 993–999, December 2014
How to Cite
Ansari, H., Ansari, Z., Lim, T., Hutson, J. M. and Southwell, B. R. (2014), Factors relating to hospitalisation and economic burden of paediatric constipation in the state of Victoria, Australia, 2002–2009. Journal of Paediatrics and Child Health, 50: 993–999. doi: 10.1111/jpc.12675
- Issue published online: 1 DEC 2014
- Article first published online: 27 JUN 2014
- Manuscript Accepted: 25 MAY 2014
- NHMRC Senior Research Fellowship
- Victorian Government Operational Infrastructural Support Program
- public health
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.