Burdens of pancreatic diseases in hospitalized children and adolescents

Background: The national data on the burdens of pancreatic diseases in children are lacking. Methods: We analyzed hospitalized patients aged <18 years under the Universal Health Scheme according to Thailand’s National Health Security Office’s data from 2015 to 2023. Results: Pancreatic diseases had a mean (SD) admission number of 212.3 (28.4) per year or 22 (3) per 100,000 admissions of all inpatient diagnoses. The admission numbers significantly upsurged in the following diagnoses: acute pancreatitis (AP) (K85) (average annual percent change, AAPC: 4.7; 95%CI:2.2 to 6.4); biliary AP (K85.1) (AAPC:6.8; 95%CI:0.3 to 13.8); and other chronic pancreatitis (CP) (K86.1) (AAPC: 9.1; 95%CI:1.5 to 17.1). The overall inpatient mortality of pancreatic diseases was 10.1 (IQR: 5.4, 10.3) per 1,000 admissions, significantly higher than all inpatient diagnoses ( P =0.04). The mean (SD) total payment for pancreatic diseases was 12,067,400 (3,342,746) THB or 375,347 (103,973) USD per year, accounting for 3.6% of all inpatient diagnoses. The payment had been rising for CP (AAPC: 12.73; 95%CI: 2.4 to 24.4) and pancreatic pseudocyst (AAPC: 12.1; 95%CI:2.4 to 23.1). Other diseases of pancreas, reported greater rates of endoscopic retrograde cholangiopancreatography and magnetic resonance cholangiopancreatography (OR:4.96; 95%CI:3.21 to 7.66, and OR:2.03; 95%CI:1.39 to 2.97, respectively) when compared to AP. Endoscopic procedures concerning the pancreatic duct were increasingly performed in children (AAPC:16.7; 95%CI:13.3 to 20.3). Conclusions: Pancreatic diseases in children that required hospitalization have a growing incidence with rising health care expenditure and intervention trends. Although the number of admissions is not high, the diseases exhibit high inpatient mortality rate.