The Journal of Pediatrics
Volume 154, Issue 2 , Pages 258-262, February 2009

Health Utilization and Cost Impact of Childhood Constipation in the United States

  • Olivia Liem, MD

      Affiliations

    • Division of Pediatric Gastroenterology, Nationwide Children's Hospital, Columbus, OH
    • Department of Pediatric Gastroenterology and Nutrition, Emma Children's Hospital, Academic Medical Center, Amsterdam, The Netherlands
    • Corresponding Author InformationReprint requests: Olivia Liem, MD, Meibergdreef 9, 1105 AZ Amsterdam, The Netherlands
  • ,
  • Jeffrey Harman, PhD

      Affiliations

    • Department of Health Services Research, Management and Policy College of Public Health and Health Professions, and University of Florida, Gainesville, FL
  • ,
  • Marc Benninga, MD, PhD

      Affiliations

    • Department of Pediatric Gastroenterology and Nutrition, Emma Children's Hospital, Academic Medical Center, Amsterdam, The Netherlands
  • ,
  • Kelly Kelleher, MD

      Affiliations

    • Division of Pediatric Gastroenterology, Nationwide Children's Hospital, Columbus, OH
  • ,
  • Hayat Mousa, MD

      Affiliations

    • Division of Pediatric Gastroenterology, Nationwide Children's Hospital, Columbus, OH
  • ,
  • Carlo Di Lorenzo, MD

      Affiliations

    • Division of Pediatric Gastroenterology, Nationwide Children's Hospital, Columbus, OH

Received 11 January 2008; received in revised form 9 June 2008; accepted 31 July 2008. published online 26 September 2008.

Objective

To estimate the total health care utilization and costs for children with constipation in the United States.

Study design

We analyzed data from 2 consecutive years (2003 and 2004) of the Medical Expenditure Panel Survey (MEPS), a nationally representative household survey. We identified children who either had been reported as constipated by their parents or had received a prescription for laxatives in a given year. Outcome measures were service utilization and expenditures.

Results

The MEPS database included a total of 21 778 children age 0 to 18 years, representing 158 million children nationally. An estimated 1.7 million US children (1.1%) reported constipation in the 2-year period. No differences with respect to age, sex, race, and socioeconomic status were found between the children with constipation and those without constipation. The children with constipation used more health services than children without constipation, resulting in significantly higher costs: $3430/year vs $1099/year. This amounts to an additional cost for children with constipation of $3.9 billion/year.

Conclusions

This study demonstrates that childhood constipation has a significant impact on the use and cost of medical care services. The estimated cost per year is 3 times than that in children without constipation, which likely is an underestimate of the actual burden of childhood constipation.

Abbreviations: AHRQ, Agency for Healthcare Research and Quality, ICD-9, International Classification of Diseases, 9th revision, MEPS, Medical Expenditure Panel Survey

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 There are no potential conflicts of interest, and no study sponsors were involved in this project.

PII: S0022-3476(08)00675-6

doi:10.1016/j.jpeds.2008.07.060

The Journal of Pediatrics
Volume 154, Issue 2 , Pages 258-262, February 2009