{"id":1769,"date":"2022-11-15T00:00:00","date_gmt":"2022-11-15T05:00:00","guid":{"rendered":"https:\/\/icesontario.wpengine.com\/journal-articles\/impact-of-antegrade-enema-initiation-on-healthcare-utilization-in-pediatric-patients-a-population-based-cohort-study\/"},"modified":"2023-11-30T14:03:01","modified_gmt":"2023-11-30T19:03:01","slug":"impact-of-antegrade-enema-initiation-on-healthcare-utilization-in-pediatric-patients-a-population-based-cohort-study","status":"publish","type":"journal_article","link":"https:\/\/www.ices.on.ca\/fr\/publications\/journal-articles\/impact-of-antegrade-enema-initiation-on-healthcare-utilization-in-pediatric-patients-a-population-based-cohort-study\/","title":{"rendered":"Impact of antegrade enema initiation on healthcare utilization in pediatric patients: a population-based cohort study"},"content":{"rendered":"<p><strong>Background<\/strong> &#x2014; When constipation is refractory to first-line interventions, antegrade enema use may be considered. We aimed to assess the impact of this intervention on healthcare utilization.<\/p>\n<p><strong>Methods<\/strong> &#x2014; We conducted a population-based, quasi-experimental study with pre&#x2013;post comparison of the intervention group and a non-equivalent control group using linked clinical and health administrative data from Ontario, Canada. Subjects included children (0&#x2013;18 years) who underwent antegrade enema initiation from 2007 to 2020 and matched controls (4:1) from the general population. To assess the change in healthcare utilization following antegrade enema initiation, we used negative binomial generalized estimating equations with covariates selected a priori.<\/p>\n<p><strong>Key Results<\/strong> &#x2014; One hundred thirty-eight subjects met eligibility criteria (appendicostomy = 55 (39.9%); cecostomy tube = 83 (60.1%)) and were matched to 550 controls. There was no significant difference in the change in the rate of hospitalizations (rate ratio (RR) 1.05, 95% confidence interval (CI) 0.35&#x2013;1.75), outpatient visits (RR 1.05, 95% CI 0.91&#x2013;1.18), or same-day surgical procedures (RR 1.51, 95% CI 0.60&#x2013;2.43) across cases in 2 years following antegrade enema initiation compared with controls. Cases had an increased rate of emergency department (ED) visits, which was not observed in controls (RR 1.52, 95% CI 1.11&#x2013;1.79), driven in part by device-related complications.<\/p>\n<p><span class=\"bold\">Conclusions and Inferences<\/span> &#x2014; Understanding healthcare utilization patterns following antegrade enema initiation allows for effective health system planning and aids medical decision-making. The observed increase in ED visits for device-related complications speaks to the need to improve preventive management to help mitigate emergency care after initiation of antegrade enemas.<\/p>\n","protected":false},"excerpt":{"rendered":"<p>Background &#x2014; When constipation is refractory to first-line interventions, antegrade enema use may be considered. We aimed to assess the impact of this intervention on healthcare utilization. Methods &#x2014; We conducted a population-based, quasi-experimental study with pre&#x2013;post comparison of the intervention group and a non-equivalent control group using linked clinical and health administrative data from [&hellip;]<\/p>\n","protected":false},"template":"","migration-helper-automated":[],"migration-manual":[],"topic":[],"migration-helper-qa-sample-set":[],"class_list":["post-1769","journal_article","type-journal_article","status-publish","hentry"],"acf":{"citation":"Gould MJ, Marcon MA, Nguyen GC, Benchimol EI, Moineddin R, Swayze S, Kopp A, Ratcliffe EM, Merritt N, Davidson J, Langer JC, Mistry N, Lorenzo AJ, Temple M, ine M Walsh CM. <em>Neurogastroenterol Motil<\/em>. 2023; 35(3):e14495. Epub 2022 Nov 15.","source_url":"https:\/\/doi.org\/10.1111\/nmo.14495","ices_scientist":[1301,1174,1327],"site":[6733],"research_program":[6746],"news_release":"","journal_article":"","atlas":"","research_report":"","infographic":"","video":"","downloads":null,"links":null,"sitecore_item_id":"2F2E5135-2E19-45DA-8315-A577D920D309","sitecore_item_name":"Impact-of-antegrade-enema-initiation-on-healthcare-utilization-in-pediatric-patients","sitecore_field_values":"{\n  \"Title\": \"Impact of antegrade enema initiation on healthcare utilization in pediatric patients: a population-based cohort study\",\n  \"Short title\": \"Impact of antegrade enema initiation\",\n  \"Summary\": \"When constipation is refractory to first-line interventions, antegrade enema use may be considered. This study aimed to assess the impact of this intervention on healthcare utilization.\",\n  \"Citation\": \"<p>Gould MJ, Marcon MA, Nguyen GC, Benchimol EI, Moineddin R, Swayze S, Kopp A, Ratcliffe EM, Merritt N, Davidson J, Langer JC, Mistry N, Lorenzo AJ, Temple M, ine M Walsh CM. <em>Neurogastroenterol Motil<\/em>. 2022; Nov 15 [Epub ahead of print]. DOI: <a href=\"https:\/\/doi.org\/10.1111\/nmo.14495\" title=\"opens external link\">https:\/\/doi.org\/10.1111\/nmo.14495<\/a><\/p>\",\n  \"Abstract\": \"<p><strong>Background<\/strong> &mdash; When constipation is refractory to first-line interventions, antegrade enema use may be considered. We aimed to assess the impact of this intervention on healthcare utilization.<\/p>n<p><strong>Methods<\/strong> &mdash; We conducted a population-based, quasi-experimental study with pre&ndash;post comparison of the intervention group and a non-equivalent control group using linked clinical and health administrative data from Ontario, Canada. Subjects included children (0&ndash;18 years) who underwent antegrade enema initiation from 2007 to 2020 and matched controls (4:1) from the general population. To assess the change in healthcare utilization following antegrade enema initiation, we used negative binomial generalized estimating equations with covariates selected a priori.<\/p>n<p><strong>Key Results<\/strong> &mdash; One hundred thirty-eight subjects met eligibility criteria (appendicostomy = 55 (39.9%); cecostomy tube = 83 (60.1%)) and were matched to 550 controls. There was no significant difference in the change in the rate of hospitalizations (rate ratio (RR) 1.05, 95% confidence interval (CI) 0.35&ndash;1.75), outpatient visits (RR 1.05, 95% CI 0.91&ndash;1.18), or same-day surgical procedures (RR 1.51, 95% CI 0.60&ndash;2.43) across cases in 2 years following antegrade enema initiation compared with controls. Cases had an increased rate of emergency department (ED) visits, which was not observed in controls (RR 1.52, 95% CI 1.11&ndash;1.79), driven in part by device-related complications.<\/p>n<p><span class=\"bold\">Conclusions and Inferences<\/span> &mdash; Understanding healthcare utilization patterns following antegrade enema initiation allows for effective health system planning and aids medical decision-making. The observed increase in ED visits for device-related complications speaks to the need to improve preventive management to help mitigate emergency care after initiation of antegrade enemas.<\/p>\",\n  \"Research Programs\": \"{CFE36C89-C969-4C23-B5E4-1BA9E5BDC273}\",\n  \"ICES Locations\": \"{4FCAABBA-14A5-42E6-8F33-BC6C2F1D9908}\",\n  \"ICES Scientists\": \"{B745F78B-F800-48D1-96E0-706773D0C8C8}|{85C78233-ED47-42C4-BF65-524CF15A8219}|{D20A13C2-789B-4AEB-9C05-64AF13F2068E}\",\n  \"Posted Date\": \"20221115T000000\",\n  \"Show on Publications Landing Page\": \"1\"\n}","previous_url":"https:\/\/www.ices.on.ca\/Publications\/Journal-Articles\/2022\/November\/Impact-of-antegrade-enema-initiation-on-healthcare-utilization-in-pediatric-patients"},"yoast_head":"<!-- This site is optimized with the Yoast SEO plugin v28.4 - https:\/\/yoast.com\/product\/yoast-seo-wordpress\/ -->\n<title>ICES | Impact of antegrade enema initiation on healthcare utilization in pediatric patients: a population-based cohort study<\/title>\n<meta name=\"description\" content=\"Background &#x2014; When constipation is refractory to first-line interventions, antegrade enema use may be considered. 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