Healthcare Burden and Cost in Children with Anorectal Malformation During the First 5 Years of Life.

Objective To identify cumulative 5-year healthcare costs and healthcare days in children with anorectal malformation (ARM) and to compare the cumulative 5-year healthcare costs and healthcare days in children with ARM to three control cohorts: healthy, premature, and congenital heart disease (CHD). Study design We performed a retrospective case-control study using the Truven MarketScan database of commercial claims encounters between 2008-2017. The ARM, CHD, and premature cohorts were identified using a targeted list of International Classification of Diseases 9th or 10th revision diagnosis and Current Procedural Terminology codes. The healthy cohort included patients without ARM, pre-term birth, or CHD. Results We identified 664 children with ARM, 3,356 children with heart disease, 63,190 pre-term children, and 2,947 healthy patients. At five years, the total healthcare costs of children with ARM ($273K, 95% CI: $168K-$378K) was similar to the premature cohort ($246K, 95% CI: $237K-$255K) and lower than the CHD cohort ($466K, 95% CI: $401K-$530K, P Conclusion Children with ARM accumulate similar healthcare costs to children with prematurity and comparable healthcare days to children with CHD and prematurity in the first five years of life. Outpatient care represents the majority of healthcare days in children with ARM identifying this as a target for quality improvement and demonstrating the long-term impact of this condition.