Concomitant Fundoplication with Gastrostomy: A Two-State Comparison Showing Continued Use of Reflux Medications.

Objectives: We sought to determine if practice differences for fundoplication exist between two geographically distinct states, and to determine the reflux medication use pattern associated with concomitant fundoplication. Methods: A retrospective observational cohort study of children in Colorado (CO) and North Carolina (NC) insured by Medicaid from 2006-2008. Children who received a surgical gastrostomy during the study period were included, and our primary outcome measure was the performance of a concomitant gastric fundoplication. Thirty-day prescription fills for reflux medications were examined pre and post gastrostomy procedure. Results: We examined 969 surgical gastrostomy admission in both states over the three year study period (CO, n = 341 and NC, n = 628). Patients in each state had similar age (Median age, 6 months, p = 0.97). Use of pH probe (CO: 15%, NC: 11%) and diagnosis of reflux (CO: 84%, NC: 72%) differed in each state. Concomitant fundoplication was performed in 60% of patients in CO and 43% in North Carolina (p

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