{"id":2012,"date":"2022-06-08T00:00:00","date_gmt":"2022-06-08T04:00:00","guid":{"rendered":"https:\/\/icesontario.wpengine.com\/journal-articles\/healthcare-utilization-and-costs-associated-with-acute-lymphoblastic-leukemia-in-children-with-and-without-down-syndrome\/"},"modified":"2023-06-14T19:24:32","modified_gmt":"2023-06-14T23:24:32","slug":"healthcare-utilization-and-costs-associated-with-acute-lymphoblastic-leukemia-in-children-with-and-without-down-syndrome","status":"publish","type":"journal_article","link":"https:\/\/www.ices.on.ca\/fr\/publications\/journal-articles\/healthcare-utilization-and-costs-associated-with-acute-lymphoblastic-leukemia-in-children-with-and-without-down-syndrome\/","title":{"rendered":"Healthcare utilization and costs associated with acute lymphoblastic leukemia in children with and without Down syndrome"},"content":{"rendered":"<p><strong>Background<\/strong> &#x2014; Children with Down syndrome (DS) and acute lymphoblastic leukemia (ALL) are at increased risk of treatment-related morbidity and mortality compared to non-DS-ALL, requiring increased supportive care. We examined the healthcare utilization and costs in DS-ALL patients to inform future evaluations of novel therapies.<\/p>\n<p><strong>Methods<\/strong> &#x2014; A provincial registry identified all children (1&#x2013;17 years) diagnosed with B-lineage ALL in Ontario, Canada between 2002 and 2012. Detailed demographic, disease, treatment, and outcome data were abstracted. Linkage to population-based health services databases identified all outpatient and emergency department (ED) visits, hospitalizations, and physician billings. Healthcare utilization costs were available for patients diagnosed during 2006&#x2013;2012 using validated algorithms (2018 Canadian dollars). Healthcare utilization rates and costs were compared between DS and non-DS patients using regression models, adjusting for all covariates.<\/p>\n<p><strong>Results<\/strong> &#x2014; Of 711 patients, 28 (3.9%) had DS. Adjusting for all covariates, children with DS-ALL experienced substantially higher rates of ED visits (rate ratio [RR] 1.5, 95% confidence interval [95% CI]: 1.2&#x2013;2.0; p = .001) and inpatient days (RR 2.5, 95% CI: 1.4&#x2013;4.5; p = .002) compared to non-DS children. Outpatient visit rates were similar (RR 1.1, 95% CI: 0.9&#x2013;1.3; <em>p<\/em> = .41). Among patients with available cost data (<em>N<\/em> = 533, DS = 19), median 5-year healthcare utilization cost was &#x24;247,700 among DS patients (interquartile range [IQR]: 200,900&#x2013;354,500) and &#x24;196,200 among non-DS patients (IQR: 148,900&#x2013;280,300; <em>p<\/em> = .02). In adjusted analyses, DS-associated costs were 50% higher (RR 1.5, 95% CI: 1.2&#x2013;1.9; <em>p<\/em> &lt; .002).<\/p>\n<p><strong>Conclusions<\/strong> &#x2014; Healthcare utilization and treatment costs of DS-ALL patients are substantially higher than those of non-DS-ALL. Our data provide a baseline for future DS-specific cost-effectiveness studies.<\/p>\n","protected":false},"excerpt":{"rendered":"<p>Background &#x2014; Children with Down syndrome (DS) and acute lymphoblastic leukemia (ALL) are at increased risk of treatment-related morbidity and mortality compared to non-DS-ALL, requiring increased supportive care. We examined the healthcare utilization and costs in DS-ALL patients to inform future evaluations of novel therapies. Methods &#x2014; A provincial registry identified all children (1&#x2013;17 years) [&hellip;]<\/p>\n","protected":false},"template":"","migration-helper-automated":[],"migration-manual":[],"topic":[],"migration-helper-qa-sample-set":[],"class_list":["post-2012","journal_article","type-journal_article","status-publish","hentry"],"acf":{"citation":"Athale U, Sutradhar R, Breakey VR, Li Q, Bassal M, Gibson P, Patel S, Wheaton L, Pole JD, Mittman N, Pechlivanoglou P, Gupta S. <em>Pediatr Blood Cancer<\/em>. 2022; e29829. Epub 2022 Jun 8.","source_url":"https:\/\/doi.org\/10.1002\/pbc.29829","ices_scientist":[1096,1370,1098,1239],"site":[6733],"research_program":[6741],"news_release":[],"journal_article":[],"atlas":[],"research_report":[],"infographic":[],"video":[],"downloads":null,"links":null,"sitecore_item_id":"A785ED98-0161-451E-B317-1D2EA78AC901","sitecore_item_name":"Healthcare-utilization-and-costs-associated-with-acute-lymphoblastic-leukemia-in-children","sitecore_field_values":"{\n  \"Content\": null,\n  \"Title\": \"Healthcare utilization and costs associated with acute lymphoblastic leukemia in children with and without Down syndrome\",\n  \"Short title\": \"Healthcare utilization and costs\",\n  \"Summary\": \"This study found that healthcare utilization and treatment costs of Down syndrome-acute lymphoblastic leukemia patients are substantially higher than those of non-Ds-ALL.\",\n  \"Citation\": \"<p>Athale U, Sutradhar R, Breakey VR, Li Q, Bassal M, Gibson P, Patel S, Wheaton L, Pole JD, Mittman N, Pechlivanoglou P, Gupta S. <em>Pediatr Blood Cancer<\/em>. 2022; e29829. Epub 2022 Jun 8. DOI: <a href=\"https:\/\/doi.org\/10.1002\/pbc.29829\" title=\"opens external link\">https:\/\/doi.org\/10.1002\/pbc.29829<\/a><\/p>\",\n  \"Abstract\": \"<p><strong>Background<\/strong> &mdash; Children with Down syndrome (DS) and acute lymphoblastic leukemia (ALL) are at increased risk of treatment-related morbidity and mortality compared to non-DS-ALL, requiring increased supportive care. We examined the healthcare utilization and costs in DS-ALL patients to inform future evaluations of novel therapies.<\/p>n<p><strong>Methods<\/strong> &mdash; A provincial registry identified all children (1&ndash;17 years) diagnosed with B-lineage ALL in Ontario, Canada between 2002 and 2012. Detailed demographic, disease, treatment, and outcome data were abstracted. Linkage to population-based health services databases identified all outpatient and emergency department (ED) visits, hospitalizations, and physician billings. Healthcare utilization costs were available for patients diagnosed during 2006&ndash;2012 using validated algorithms (2018 Canadian dollars). Healthcare utilization rates and costs were compared between DS and non-DS patients using regression models, adjusting for all covariates.<\/p>n<p><strong>Results<\/strong> &mdash; Of 711 patients, 28 (3.9%) had DS. Adjusting for all covariates, children with DS-ALL experienced substantially higher rates of ED visits (rate ratio [RR] 1.5, 95% confidence interval [95% CI]: 1.2&ndash;2.0; p = .001) and inpatient days (RR 2.5, 95% CI: 1.4&ndash;4.5; p = .002) compared to non-DS children. Outpatient visit rates were similar (RR 1.1, 95% CI: 0.9&ndash;1.3; <em>p<\/em> = .41). Among patients with available cost data (<em>N<\/em> = 533, DS = 19), median 5-year healthcare utilization cost was $247,700 among DS patients (interquartile range [IQR]: 200,900&ndash;354,500) and $196,200 among non-DS patients (IQR: 148,900&ndash;280,300; <em>p<\/em> = .02). In adjusted analyses, DS-associated costs were 50% higher (RR 1.5, 95% CI: 1.2&ndash;1.9; <em>p<\/em> &lt; .002).<\/p>n<p><strong>Conclusions<\/strong> &mdash; Healthcare utilization and treatment costs of DS-ALL patients are substantially higher than those of non-DS-ALL. Our data provide a baseline for future DS-specific cost-effectiveness studies.<\/p>\",\n  \"Research Programs\": \"{85DE96A6-4C96-40C7-8E6D-7597A0EB5F80}\",\n  \"ICES Locations\": \"{4FCAABBA-14A5-42E6-8F33-BC6C2F1D9908}\",\n  \"ICES Scientists\": \"{DE62616B-A5F1-4283-A304-BB08AD148F94}|{56BF24FA-D81E-4114-BF1F-4715A424E26C}|{F5F3AB6E-CD96-4F14-BDD6-206C43AC2DD3}|{92701820-E853-436C-8AD9-173545BA0A7D}\",\n  \"Posted Date\": \"20220608T000000\",\n  \"Show on Publications Landing Page\": \"1\"\n}","previous_url":"https:\/\/www.ices.on.ca\/Publications\/Journal-Articles\/2022\/June\/Healthcare-utilization-and-costs-associated-with-acute-lymphoblastic-leukemia-in-children"},"yoast_head":"<!-- This site is optimized with the Yoast SEO plugin v27.7 - https:\/\/yoast.com\/product\/yoast-seo-wordpress\/ -->\n<title>ICES | Healthcare utilization and costs associated with acute lymphoblastic leukemia in children with and without Down syndrome<\/title>\n<meta name=\"description\" content=\"Background &#x2014; Children with Down syndrome (DS) and acute lymphoblastic leukemia (ALL) are at increased risk of treatment-related morbidity and\" \/>\n<meta name=\"robots\" content=\"index, follow, max-snippet:-1, max-image-preview:large, max-video-preview:-1\" \/>\n<link rel=\"canonical\" href=\"https:\/\/www.ices.on.ca\/fr\/publications\/journal-articles\/healthcare-utilization-and-costs-associated-with-acute-lymphoblastic-leukemia-in-children-with-and-without-down-syndrome\/\" \/>\n<meta property=\"og:locale\" content=\"fr_FR\" \/>\n<meta property=\"og:type\" content=\"article\" \/>\n<meta property=\"og:title\" content=\"ICES | Healthcare utilization and costs associated with acute lymphoblastic leukemia in children with and without Down syndrome\" \/>\n<meta property=\"og:description\" content=\"Background &#x2014; Children with Down syndrome (DS) and acute lymphoblastic leukemia (ALL) are at increased risk of treatment-related morbidity and\" \/>\n<meta property=\"og:url\" content=\"https:\/\/www.ices.on.ca\/fr\/publications\/journal-articles\/healthcare-utilization-and-costs-associated-with-acute-lymphoblastic-leukemia-in-children-with-and-without-down-syndrome\/\" \/>\n<meta property=\"og:site_name\" content=\"ICES\" \/>\n<meta property=\"article:publisher\" content=\"https:\/\/www.facebook.com\/ICESOntario\/\" \/>\n<meta property=\"article:modified_time\" content=\"2023-06-14T23:24:32+00:00\" \/>\n<meta property=\"og:image\" content=\"https:\/\/www.ices.on.ca\/wp-content\/uploads\/2024\/11\/ic-es-data-discovery-better-health-logo.jpg\" \/>\n\t<meta property=\"og:image:width\" content=\"1200\" \/>\n\t<meta property=\"og:image:height\" content=\"675\" \/>\n\t<meta property=\"og:image:type\" content=\"image\/jpeg\" \/>\n<meta name=\"twitter:card\" content=\"summary_large_image\" \/>\n<script type=\"application\/ld+json\" class=\"yoast-schema-graph\">{\"@context\":\"https:\\\/\\\/schema.org\",\"@graph\":[{\"@type\":\"WebPage\",\"@id\":\"https:\\\/\\\/www.ices.on.ca\\\/fr\\\/publications\\\/journal-articles\\\/healthcare-utilization-and-costs-associated-with-acute-lymphoblastic-leukemia-in-children-with-and-without-down-syndrome\\\/\",\"url\":\"https:\\\/\\\/www.ices.on.ca\\\/fr\\\/publications\\\/journal-articles\\\/healthcare-utilization-and-costs-associated-with-acute-lymphoblastic-leukemia-in-children-with-and-without-down-syndrome\\\/\",\"name\":\"ICES | Healthcare utilization and costs associated with acute lymphoblastic leukemia in children with and without Down syndrome\",\"isPartOf\":{\"@id\":\"https:\\\/\\\/www.ices.on.ca\\\/fr\\\/#website\"},\"datePublished\":\"2022-06-08T04:00:00+00:00\",\"dateModified\":\"2023-06-14T23:24:32+00:00\",\"description\":\"Background &#x2014; 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