title: Health utilization and cost impact of childhood constipation in the United States.
abstract: OBJECTIVE
  To estimate the total health care utilization and costs for children with constipation in the United States.
  
  
  METHODS
  We analyzed data from 2 consecutive years (2003 and 2004) of the Medical Expenditure Panel Survey (MEPS), a nationally representative household survey. We identified children who either had been reported as constipated by their parents or had received a prescription for laxatives in a given year. Outcome measures were service utilization and expenditures.
  
  
  RESULTS
  The MEPS database included a total of 21 778 children age 0 to 18 years, representing 158 million children nationally. An estimated 1.7 million US children (1.1%) reported constipation in the 2-year period. No differences with respect to age, sex, race, and socioeconomic status were found between the children with constipation and those without constipation. The children with constipation used more health services than children without constipation, resulting in significantly higher costs: $3430/year vs $1099/year. This amounts to an additional cost for children with constipation of $3.9 billion/year.
  
  
  CONCLUSIONS
  This study demonstrates that childhood constipation has a significant impact on the use and cost of medical care services. The estimated cost per year is 3 times than that in children without constipation, which likely is an underestimate of the actual burden of childhood constipation.
authors.affiliation: Division of Pediatric Gastroenterology, Nationwide Children's Hospital, Columbus, OH, USA. o.liem@amc.uva.nl
authors.forename: Olivia
authors.initials: O
authors.lastname: Liem
authors.forename: Jeffrey
authors.initials: J
authors.lastname: Harman
authors.forename: Marc
authors.initials: M
authors.lastname: Benninga
authors.forename: Kelly
authors.initials: K
authors.lastname: Kelleher
authors.forename: Hayat
authors.initials: H
authors.lastname: Mousa
authors.forename: Carlo
authors.initials: C
authors.lastname: Di Lorenzo
mesh_terms: D000041:Absenteeism; D000293:Adolescent; D000553:Ambulatory Care / Q000706:statistics & numerical data; D002648:Child; D002675:Child, Preschool; D003248:Constipation / Q000191:economics* / Q000453:epidemiology*; D004636:Emergency Service, Hospital / Q000706:statistics & numerical data; D005260:Female; D005102:Health Expenditures; D006306:Health Surveys; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D054368:Laxatives / Q000191:economics / Q000627:therapeutic use; D008297:Male; D010290:Parents; D012044:Regression Analysis; D018582:Sick Leave / Q000191:economics / Q000706:statistics & numerical data; D014481:United States / Q000453:epidemiology
chemical_list: D054368:Laxatives