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ORIGINAL ARTICLE
Year : 2018  |  Volume : 37  |  Issue : 4  |  Page : 600-605

Economics and clinical implications of delayed presentation of children with intussusceptions: minimizing healthcare cost in the context of limited resources


1 Department of Surgery, Division of Pediatric Surgery, Ilorin, Nigeria
2 Department of Surgery, Federal Medical Centre, Owo, Nigeria
3 Department of Radiology, University of Ilorin Teaching Hospital, Ilorin, Nigeria
4 Department of Pediatric, University of Ilorin, Ilorin, Nigeria

Correspondence Address:
Abdulrasheed A Nasir
Department of Surgery, Division of Pediatric Surgery, University of Ilorin Teaching Hospital, University of Ilorin, PMB 1459, Ilorin, 234001
Nigeria
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/ejs.ejs_113_18

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Background A basic strategy in today’s resource-limited healthcare environment is limiting cost while maintaining quality. Objective To estimate the impact and healthcare cost of treatment of intussusceptions (ISs) presenting late. Patients and methods We performed a chart review of children managed for ISs over 44 months. Our care pathway included resuscitation, ultrasound-guided hydrostatic reduction of children presenting early (≤24 h) with no peritonitis. Results There were 46 children seen at a median age of 8.5 months. Thirty-two (69.6%) presented late (>24 h). The total charge was higher for patients who presented late ($259.6 vs. $168.9, P=0.012). There was an average of 21% ($50.0) additional charges incurred for each day’s delay. There was significantly higher cost of drugs ($45.1 vs. $23.7, P=0.008) and procedures ($154.4 vs. $99.5, P=0.025). Those who presented late had increased risk of bowel resection (40 vs. 0%, odds ratio=1.74, P=0.005), and higher complication rates (56 vs. 21%, odds ratio=0.21, P=0.018). The length of stay was doubled for those who presented late (10.6 vs. 4.6 days, P=0.001). Conclusion Delayed presentation of ISs translates to increased hospital cost and an extra week in hospital with increased morbidity.


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