Back to Search
Start Over
Impact of antegrade enema initiation on healthcare utilization in pediatric patients: A populationābased cohort study
- Source :
- Neurogastroenterology & Motility. 35
- Publication Year :
- 2022
- Publisher :
- Wiley, 2022.
-
Abstract
- 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.We conducted a population-based, quasi-experimental study with pre-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 (0-18 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.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) 0.35-1.75), outpatient visits (RR 1.05, 95% CI 0.91-1.18), or same-day surgical procedures (RR 1.51, 95% CI 0.60-2.43) 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 1.11-1.79), driven in part by device-related complications.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.
- Subjects :
- Endocrine and Autonomic Systems
Physiology
Gastroenterology
Subjects
Details
- ISSN :
- 13652982 and 13501925
- Volume :
- 35
- Database :
- OpenAIRE
- Journal :
- Neurogastroenterology & Motility
- Accession number :
- edsair.doi.dedup.....da881d26a3a1557bbaf10df513057dd8