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National Burden of Pediatric Hospitalizations for Inflammatory Bowel Disease: Results From the 2006 Kids’ Inpatient Database

Heaton, Pamela C.*; Tundia, Namita L.*; Schmidt, Nicole; Wigle, Patricia R.; Kelton, Christina M.L.§

Journal of Pediatric Gastroenterology & Nutrition: April 2012 - Volume 54 - Issue 4 - p 477–485
doi: 10.1097/MPG.0b013e318239bc79
Original Articles: Gastroenterology

Objectives: The objective of the present study was to quantify the national pediatric inpatient inflammatory bowel disease (IBD) burden in terms of the number of IBD-related hospitalizations, the number of days spent in the hospital, and hospitalization costs.

Methods: Hospitalizations for children and adolescents 20 years and younger with a primary diagnosis of either Crohn disease (CD) or ulcerative colitis (UC) were selected from the 2006 Kids’ Inpatient Database (KID). Length of the hospital stay in days (LOS) and charges for the hospitalization were found directly in the Kids’ Inpatient Database, and cost was calculated using the hospital's cost-to-charge ratio. Predictor variables included patient characteristics, such as age and severity of illness, and hospital characteristics. Ordinary-least-squares regressions were developed and estimated to explain hospitalization costs.

Results: In 2006, there were 10,777 IBD-related hospitalizations. The total and mean costs for CD were $66.3 million and $10,176 (95% confidence interval [CI] $9647–$10,705), and for UC were $48.6 million and $11,836 (95% CI $10,760-$12,912). For CD, 0- to 5-year-old patients had the highest mean LOS (8.10, 95% CI 5.53–10.67, days) and mean cost ($13,894, 95% CI $9053–$18,735), whereas, for UC, 11- to 15-year-old patients had the highest mean LOS (7.49, 95% CI 6.88–8.10, 95% CI 5.53–10.67, days) and mean cost ($13,407, 95% CI $11,704–$15,110).

Conclusions: For a pediatric disease with a rather low prevalence rate, the estimated annual inpatient pediatric burden of IBD is a sizeable $152.4 million (2010 US$) and 64,985 days spent in the hospital. As medications and outpatient treatments improve for the treatment of IBD, there is an opportunity for significant reduction in inpatient burden.

*College of Pharmacy, University of Cincinnati

Department of Surgery, Division of Transplantation, University of Cincinnati Medical Center

College of Pharmacy

§College of Business and College of Pharmacy, University of Cincinnati, Cincinnati, OH.

Address correspondence and reprint requests to Pamela C. Heaton, PhD, College of Pharmacy, University of Cincinnati, 3225 Eden Ave, Cincinnati, OH 45267-0004 (e-mail:

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Received 7 March, 2011

Accepted 21 September, 2011

This project was supported in part by cooperative agreement number U18 HS016957-03 from the Agency for Healthcare Research and Quality for the Center for Education and Research on Therapeutics, Cincinnati Children's Hospital Medical Center. The content is solely the responsibility of the authors and does not necessarily represent the official views of the Agency for Healthcare Research and Quality.

An earlier version of the present study was presented as an unpublished poster at the Annual Meeting of the International Society for Pharmacoeconomics and Outcomes Research in Atlanta, GA, May 15–19, 2010.

The authors report no conflicts of interest.

Copyright 2012 by ESPGHAN and NASPGHAN