Epidemiology and the cost burden of hospitalized pediatric-onset inflammatory bowel disease in China: A national database study.

IF 2 4区医学 Q2 PEDIATRICS

Pediatric Investigation Pub Date : 2025-04-11 eCollection Date: 2025-09-01 DOI:10.1002/ped4.70000

Xiaolu Nie, Jing Li, Hui Xu, Fang Hu, Xiaolin Ye, Mengmeng Yu, Guoshuang Feng, Yueping Zeng, Xin Ni, Jie Wu, Xiaoxia Peng

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Abstract

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.

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中国儿科住院炎症性肠病的流行病学和费用负担：一项国家数据库研究

重要性：了解儿科起病炎症性肠病（PIBD）的流行病学和费用负担对于阐明其发病机制和制定医疗保险决策至关重要，特别是对于非常早发的IBD （VEO-IBD）。目的：了解PIBD和VEO-IBD住院患者的流行病学及费用负担。方法：一项多中心研究，使用中国大陆28家医院（2016-2021）的福堂更新病历数据库，识别0-18岁的PIBD住院患者。分析了社会人口学、临床特征、住院时间（LOS）和费用数据。费用负担是用每年的自付支出除以家庭可支配收入来评估的。比较克罗恩病（CD）、溃疡性结肠炎（UC）、IBD-unclassified （IBD-U）和不同年龄组的临床流行病学和费用负担。结果：共发现5230例PIBD住院病例。CD患者（11.8±3.9岁）和UC患者（8.0±5.2岁）的平均年龄明显高于IBD-U患者（4.5±4.1岁）。因乳糜泻住院的人数逐年显著增加。CD患者的LOS（中位3天）短于UC患者（中位6天）和IBD-U患者（中位7天）。2016-2021年，VEO-CD住院人数增加，VEO-UC住院人数下降。总住院费用中位数为乳糜泻1006.7美元，UC 841.6美元。2016 - 2021年，每名PIBD患者每年IBD费用负担的平均比例分别为16.47%、14.34%、20.55%、18.45%、12.13%和11.16%，自2020年以来下降明显。解释：本研究揭示了中国PIBD和VEO-IBD的临床特征和成本负担。PIBD的住院治疗，特别是CD的住院治疗正在增加。指导方针和健康保险政策可以帮助减轻这一费用负担。

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