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Gastroschisis: the cost of an epidemic

Presented at the Neonatal Society 2007 Summer Meeting (programme).

Keys C, Drewett M, Burge DM

Department of Surgical Paediatrics, Southampton University NHS Hospital Trust, Tremona Road, Southampton SO16 6YD, UK

Background: The rising incidence of gastroschisis has been highlighted by the Department of Health as a growing concern (1). Its aetiology remains unknown (2). As well as the health implications for the increasing number of affected infants this increase in incidence will have an impact on the costs of health care. This study was undertaken to estimate the financial cost of treating this condition in one tertiary neonatal surgical centre.

Methods: A retrospective analysis was performed of all patients admitted to a tertiary neonatal surgical centre with gastroschisis from January 1996 to December 2005. The main outcome measures were incidence, length of hospital stay and total cost for all patients each year.

Results: The total number of patients was 106. The incidence of gastroschisis has risen 3-fold in 10 years. The median cost per patient is relatively constant. A few patients with severe intestinal dysmotility require prolonged hospital stay. As the condition becomes more common there are an increasing number of complex patients and thus an increase in annual costs, which is disproportionate to the increase in numbers of cases. We estimate that the annual cost to the NHS of this condition in England and Wales has risen from 3.6m in 1996 to in excess of 15m in 2005.

Conclusions: Urgent research is required into the aetiology of gastroschisis and into the severe intestinal dysmotility that occurs in some complex patients.

We confirm that this study did not require ethics committee approval and that this study was carried out independently from research funders.

1. Donaldson L. Gastroschisis: a growing concern. London: Department of Health, CMO Annual report 2004.
2. Curry JI, McKinney P, Thornton JG, et al: The aetiology of gastroschisis. Br J Obstet Gynae 107:1339-1346, 2000

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