Pediatric investigation · 2025
Epidemiology and the cost burden of hospitalized pediatric-onset inflammatory bowel disease in China: A national database study.
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Nie Xiaolu, Li Jing, Xu Hui, Hu Fang, Ye Xiaolin, Yu Mengmeng, Feng Guoshuang, Zeng Yueping, Ni Xin, Wu Jie, Peng Xiaoxia, Futang Research Center of Pediatric Development (FRCPD)
Аннотация
IMPORTANCE: Understanding the epidemiology and cost burden of pediatric-onset inflammatory bowel disease (PIBD) is crucial for shedding light on its pathogenesis and making medical insurance decisions, particularly for very early-onset IBD (VEO-IBD).
OBJECTIVE: To assess the epidemiology and cost burden of hospitalized PIBD and VEO-IBD.
METHODS: A multicenter study identified hospitalized PIBD patients aged 0-18 years using the FUTang Updating medical REcords database from 28 hospitals in mainland China (2016-2021). Sociodemographic, clinical characteristics, length of stay (LOS), and expense data were analyzed. The cost burden was evaluated by dividing annual out-of-pocket expenditure by household disposable income. Clinical epidemiology and cost burden were compared between Crohn's disease (CD), ulcerative colitis (UC), IBD-unclassified (IBD-U), and different age groups.
RESULTS: A total of 5230 hospitalized cases of PIBD were identified. Mean ages for CD (11.8 ± 3.9 years) and UC (8.0 ± 5.2 years) were significantly higher than those of patients with IBD-U (4.5 ± 4.1 years). Hospitalizations for CD showed a notable annual increase. Patients with CD had a shorter LOS (median 3 days) than those with UC (median 6 days) and IBD-U (median 7 days). The number of VEO-CD hospitalizations increased, while that of VEO-UC declined (2016-2021). The median total hospitalization expenses were $1006.7 for CD and $841.6 for UC. The average proportion of annual cost burden of IBD for each PIBD patient from 2016 to 2021 was 16.47%, 14.34%, 20.55%, 18.45%, 12.13%, and 11.16%, respectively, which has declined significantly since 2020.
INTERPRETATION: This study provides insight into the clinical characteristics and cost burden of PIBD and VEO-IBD in China. Hospitalizations for PIBD, particularly for CD, are increasing. Guidelines and health insurance policies can help mitigate this cost burden.
OBJECTIVE: To assess the epidemiology and cost burden of hospitalized PIBD and VEO-IBD.
METHODS: A multicenter study identified hospitalized PIBD patients aged 0-18 years using the FUTang Updating medical REcords database from 28 hospitals in mainland China (2016-2021). Sociodemographic, clinical characteristics, length of stay (LOS), and expense data were analyzed. The cost burden was evaluated by dividing annual out-of-pocket expenditure by household disposable income. Clinical epidemiology and cost burden were compared between Crohn's disease (CD), ulcerative colitis (UC), IBD-unclassified (IBD-U), and different age groups.
RESULTS: A total of 5230 hospitalized cases of PIBD were identified. Mean ages for CD (11.8 ± 3.9 years) and UC (8.0 ± 5.2 years) were significantly higher than those of patients with IBD-U (4.5 ± 4.1 years). Hospitalizations for CD showed a notable annual increase. Patients with CD had a shorter LOS (median 3 days) than those with UC (median 6 days) and IBD-U (median 7 days). The number of VEO-CD hospitalizations increased, while that of VEO-UC declined (2016-2021). The median total hospitalization expenses were $1006.7 for CD and $841.6 for UC. The average proportion of annual cost burden of IBD for each PIBD patient from 2016 to 2021 was 16.47%, 14.34%, 20.55%, 18.45%, 12.13%, and 11.16%, respectively, which has declined significantly since 2020.
INTERPRETATION: This study provides insight into the clinical characteristics and cost burden of PIBD and VEO-IBD in China. Hospitalizations for PIBD, particularly for CD, are increasing. Guidelines and health insurance policies can help mitigate this cost burden.