title: Direct Costs of Acute Recurrent and Chronic Pancreatitis in Children in the INSPPIRE Registry.
abstract: OBJECTIVE
  To estimate selected direct medical care costs of children with chronic pancreatitis (CP) and acute recurrent pancreatitis (ARP).
  
  
  METHODS
  We performed a cross-sectional study of data from International Study Group of Pediatric Pancreatitis: In Search for a Cure (INSPPIRE), a multinational registry of children with ARP or CP. We determined health care utilization and estimated costs of hospitalizations, surgical and endoscopic procedures, and medications in our study population. Health care utilization data were obtained from all subjects enrolled in the study, and costs were calculated using national United States costs.
  
  
  RESULTS
  We included 224 subjects (median age 12.7 years), 42% of whom had CP. Mean number of hospitalizations, including for surgery and endoscopic retrograde cholangiopancreatography, was 2.3 per person per year, costing an estimated average $38,755 per person per year. Including outpatient medications, estimated total mean cost was $40,589 per person per year. Subjects using surgical procedures or endoscopic retrograde cholangiopancreatography incurred mean annual costs of $42,951 per person and $12,035 per person, respectively. Estimated annual costs of pancreatic enzyme replacement therapy, diabetic medications, and pain medications were $4114, $1761, and $614 per person, respectively. In an exploratory analysis, patients with the following characteristics appear to accrue higher costs than those without them: more frequent ARP attacks per year, reported constant or episodic pain, family history of pancreatic cancer, and use of pain medication.
  
  
  CONCLUSIONS
  ARP and CP are uncommon childhood conditions. The severe burden of disease associated with these conditions and their chronicity results in high health care utilization and costs. Interventions that reduce the need for hospitalization could lower costs for these children and their families.
authors.affiliation: *University of California, San Francisco †University of Minnesota Masonic Children's Hospital, Minneapolis ‡Baylor College of Medicine, Houston, TX §University of Texas Southwestern Medical School, Dallas ||Hospital for Sick Children, Toronto, ON, Canada ¶Harvard Medical School, Boston, MA #Nationwide Children's Hospital, Columbus, OH **Seattle Children's Hospital, Seattle, WA ††Children's Hospital of Pittsburgh, Pittsburgh, PA ‡‡Montreal Children's Hospital, McGill University, Montreal, QC, Canada §§Discipline of Paediatrics, School of Women's and Children's Health, Medicine, University of New South Wales and Sydney Children's Hospital Randwick, Sydney, Australia ||||University of Utah, Salt Lake City, UT ¶¶Medical College of Wisconsin, Milwaukee, WI ##Hadassah Hebrew University Hospital, Jerusalem, Israel ***University of Iowa Carver College of Medicine, IA.
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mesh_terms: D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D003430:Cross-Sectional Studies; D005260:Female; D017048:Health Care Costs / Q000706:statistics & numerical data*; D017721:Hospital Costs / Q000706:statistics & numerical data*; D006760:Hospitalization / Q000191:economics* / Q000706:statistics & numerical data; D006801:Humans; D007223:Infant; D008297:Male; D010195:Pancreatitis / Q000191:economics*; D010342:Patient Acceptance of Health Care / Q000706:statistics & numerical data*; D012008:Recurrence; D012042:Registries; D055815:Young Adult