Faculty Collaboration Database

Healthcare Utilization and Comorbidities Associated with Anorectal Malformations in the United States. J Pediatr 2018 Mar;194:142-146

Date

12/05/2017

Pubmed ID

29198537

DOI

10.1016/j.jpeds.2017.10.010

Scopus ID

2-s2.0-85035749872 (requires institutional sign-in at Scopus site)   13 Citations

Abstract

OBJECTIVE: To determine nationwide prevalence and healthcare utilization in children with anorectal malformations and associated anomalies over a 6-year period.

STUDY DESIGN: We used the Kids' Inpatient Database for the years 2006, 2009, and 2012 for data collection. International Classification of Diseases, Ninth Revision codes were used to identify patients with anorectal malformations and associated anomalies.

RESULTS: A total of 2396 children <2 years of age with anorectal malformations were identified using weighted analysis; 54.3% of subjects were male. The ethnic subgroups were 40.1% white, 23.6% Hispanic, 9.3% African American, and 27% other ethnicity. Other congenital anomalies were reported in 80% of anorectal malformations and were closely associated with increased length of stay and costs. A genetic disorder was identified in 14.1% of the sample. Urogenital anomalies were present in 38.5%, heart anomalies in 21.2%, and 8.6% had vertebral anomalies, anal atresia, cardiac defects, tracheoesophageal fistula and/or esophageal atresia, renal anomalies, and limb defects association. Anorectal malformations with other anomalies including vertebral anomalies, anal atresia, cardiac defects, tracheoesophageal fistula and/or esophageal atresia, renal anomalies, and limb defects association incurred significant hospital charges when compared with anorectal malformations alone. The average annual healthcare expenditure for surgical correction of anorectal malformations and associated anomalies for the 3 years was US $45.5 million.

CONCLUSIONS: This large, major nationally representative study shows that majority of children with anorectal malformations have additional congenital anomalies that deserve prompt recognition. The high complexity and need for lifelong multidisciplinary management is associated with substantial healthcare expenditure. This information complements future healthcare resource allocation and planning for management of children with anorectal malformations.

Author List

Kovacic K, Matta SR, Kovacic K, Calkins C, Yan K, Sood MR

Authors

Casey Matthew Calkins MD Professor in the Surgery department at Medical College of Wisconsin
Katja K. Karrento MD Associate Professor in the Pediatrics department at Medical College of Wisconsin
Karlo Kovacic MD Assistant Professor in the Pediatrics department at Medical College of Wisconsin
Ke Yan PhD Associate Professor in the Pediatrics department at Medical College of Wisconsin

MESH terms used to index this publication - Major topics in bold

Anorectal Malformations
Comorbidity
Cost of Illness
Cross-Sectional Studies
Databases, Factual
Female
Health Care Costs
Humans
Infant
Infant, Newborn
Male
Patient Acceptance of Health Care
Prevalence
United States