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The cost of childhood intussusception in Ontario from 2003 to 2016: a population-based study

Pilkington M, Khong E, Brogly SB, Winthrop A, Kolar M. J Pediatr Surg. 2020; Jan 31 [Epub ahead of print]. DOI: https://doi.org/10.1016/j.jpedsurg.2020.01.035


Background — Management of pediatric intussusception has evolved to favor non-surgical reduction with potential outpatient management. The overall impact of these changes on healthcare costs is unknown.

Methods — A retrospective longitudinal cohort study was conducted utilizing population-based universal-access administrative healthcare data to identify patients < 18 years treated for intussusception January 2003–December 2016 in Ontario, Canada. Hospital-associated cost included emergency department and cost of hospitalization, while total cost also included billable physician costs. All costs are presented in 2016 Canadian Dollars.

Results — The median hospital-associated costs for each modality were: non-surgical $2467, failed non-surgical $6508, and surgical only $8863 (p < 0.0001). Costs associated with non-surgical or surgical only management did not change over the study period, whereas costs associated with failed non-surgical management increased from $3842 in 2003 to $12,350 in 2016 (p = 0.0003). Similar trends were observed when physician billing data was included. Costs were $1076.95 higher in community hospitals than academic hospitals (95% CI: $344, $1810; p = 0.004).

Conclusion — The cost of care for intussusception is dependent upon treatment modality and was lowest for non-surgical management and highest for patients treated in community hospitals. Efforts to standardize care to promote successful non-surgical management and to facilitate early discharge could provide cost savings to the healthcare system.

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