John S Lam1, Alberto Breda, Peter G Schulam. 1. Department of Urology, David Geffen School of Medicine at University of California-Los Angeles, Los Angeles, California 90095-1738, USA. jlam@mednet.ucla.edu
Abstract
PURPOSE: We quantified the burden of ureteropelvic junction obstruction in the United States by identifying trends in the use of health care resources and estimating the economic impact of the disease. MATERIALS AND METHODS: The analytical methods used to generate these results were described previously. RESULTS: Inpatient hospitalization rates were highest in children younger than 3 years. Most patients were male and hospitalizations occurred almost exclusively at urban centers. Patients with a primary diagnosis of ureteropelvic junction obstruction between 1994 and 2000 had an overall decrease in the age adjusted rate of inpatient hospitalization from 1.1/100,000 to 0.8/100,000. Physician office visits by Medicare beneficiaries with ureteropelvic junction obstruction as the primary diagnosis showed stable overall age adjusted rates during the reported years. Between 1999 and 2003 mean inpatient length of stay and cost per child hospitalized with the primary diagnosis of ureteropelvic junction obstruction was 2.9 days and $7,728, respectively. Average length of stay decreased more for children than for adults but total inpatient spending remained stable at about $12 million. CONCLUSIONS: The majority of ureteropelvic junction obstructions are diagnosed in the perinatal period. Surgical intervention for pediatric patients has decreased with time, while there has been an increasing trend toward the conservative management of this condition.
PURPOSE: We quantified the burden of ureteropelvic junction obstruction in the United States by identifying trends in the use of health care resources and estimating the economic impact of the disease. MATERIALS AND METHODS: The analytical methods used to generate these results were described previously. RESULTS: Inpatient hospitalization rates were highest in children younger than 3 years. Most patients were male and hospitalizations occurred almost exclusively at urban centers. Patients with a primary diagnosis of ureteropelvic junction obstruction between 1994 and 2000 had an overall decrease in the age adjusted rate of inpatient hospitalization from 1.1/100,000 to 0.8/100,000. Physician office visits by Medicare beneficiaries with ureteropelvic junction obstruction as the primary diagnosis showed stable overall age adjusted rates during the reported years. Between 1999 and 2003 mean inpatient length of stay and cost per child hospitalized with the primary diagnosis of ureteropelvic junction obstruction was 2.9 days and $7,728, respectively. Average length of stay decreased more for children than for adults but total inpatient spending remained stable at about $12 million. CONCLUSIONS: The majority of ureteropelvic junction obstructions are diagnosed in the perinatal period. Surgical intervention for pediatric patients has decreased with time, while there has been an increasing trend toward the conservative management of this condition.
Authors: Jens Drube; Petra Zürbig; Eric Schiffer; Esther Lau; Benno Ure; Sylvia Glüer; Martin Kirschstein; Lars Pape; Stéphane Decramer; Jean-Loup Bascands; Joost P Schanstra; Harald Mischak; Jochen H H Ehrich Journal: Pediatr Nephrol Date: 2010-02-24 Impact factor: 3.714