Original Article

Factors relating to hospitalisation and economic burden of paediatric constipation in

the state of Victoria, Australia, 2002–2009

Humaira Ansari Zahid Ansari Tracy Lim John M Hutson Bridget R Southwell
First published: 27 June 2014

Abstract
Constipation is common, with severe symptoms requiring hospitalisation. Constipation can
be a primary (present at admission and requires treatment or investigation) or principal (first
listed) diagnosis for hospitalisation. In the USA, constipation is the second most common
ambulatory care digestive diagnosis with total costs >US$1.7 billion/year. Incidence of
hospitalisation for constipation in children peaks at toilet-training age. This study determined
the burden of paediatric constipation to hospital care in Victoria, Australia.

Method
The Victorian Admitted Episodes Dataset was analysed retrospectively, examining hospital
admissions with a primary diagnosis of constipation in the 7-year period 2002/2003 to
2008/2009.

Results
For children, constipation was recorded as a primary diagnosis in 8688 admissions
(3.6/1000 of population). In-hospital prevalence was ∼1.0%. Mean length of stay was
4.4 days (median 1.0, range 0–993, standard deviation 16.7). There were 1121
readmissions in 668 children. Average treatment cost was A$4235/admission (median
A$1461, range A$0–$278 816), with annual costs of ∼A$5 505 500. Children in the highest
socio-economic area had ∼50% fewer admissions (P < 0.0001). Predictors of readmission
included age 10–18, male gender, rural residence, severe socio-economic disadvantage,
public hospital, planned admission, longer length of stay and association with other medical
conditions.

Conclusions
This study identified that constipation in children is a significant cost burden in Victoria
(costing public hospitals ∼A$5.5 million/year). Hospitalisation in Victoria is 10-fold higher
than in the USA with 10% readmissions within a month. We conclude that strategies aimed
at reducing hospitalisation for constipation could result in significant savings for the
paediatric public health system in Victoria, Australia.

Citing Literature
Number of times cited: 4
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Jarno Melenhorst, Marc A. Benninga, Cor G. M. I. Baeten and Stephanie O. Breukink, Sacral
neuromodulation in children and adolescents with chronic constipation refractory to
conservative treatment, International Journal of Colorectal Disease, 31, 8, (1459), (2016).
Crossref
Shaman Rajindrajith, Niranga Manjuri Devanarayana, Bonaventure Jayasiri Crispus Perera
and Marc Alexander Benninga, Childhood constipation as an emerging public health
problem, World Journal of Gastroenterology, 10.3748/wjg.v22.i30.6864, 22, 30, (6864),
(2016).
Crossref
Julie Jordan-Ely, John M Hutson and Bridget R Southwell, Disimpaction of children with
severe constipation in 3–4 days in a suburban clinic using polyethylene glycol with
electrolytes and sodium picosulphate, Journal of Paediatrics and Child Health, 51, 12,
(1195-1198), (2015).
Wiley Online Library
Kasturi Waingankar, Christoper Lai, Vishal Punwani, Jeremy Wong, John M Hutson and
Bridget R Southwell, Dietary exclusion of fructose and lactose after positive breath tests
improved rapid-transit constipation in children, JGH Open, , (2018).
Wiley Online Library