Allison C Redpath Mahon1, Troy Richardson2, Alicia M Neu3, Bradley A Warady4. 1. Division of Pediatric Nephrology, University of Wisconsin American Family Children's Hospital, 600 Highland Avenue, Madison, WI, 53792, USA. acredpath@pediatrics.wisc.edu. 2. Children's Hospital Association, 16011 College Blvd., Suite 250, Lenexa, KS, 66219, USA. 3. Division of Pediatric Nephrology, Johns Hopkins University School of Medicine, 200 N. Wolfe Street, Room 3065, Baltimore, MD, 21287, USA. 4. Division of Pediatric Nephrology, Children's Mercy Kansas City, 2401 Gillham Rd., Kansas City, MO, 64108, USA.
Abstract
BACKGROUND: Although peritonitis causes significant morbidity and mortality in children receiving chronic peritoneal dialysis (CPD), little is known about costs associated with treatment. METHODS: We analyzed 246 peritonitis-related hospitalizations in the USA, linked by the Standardized Care to Improve Outcomes in Pediatric End Stage Renal Disease (SCOPE) and Pediatric Health Information Systems (PHIS) databases. Multivariable logistic regression was used to assess the relationship between high-cost hospitalizations (at or above the 75th percentile) and patient characteristics. Multivariable modeling was used to assess differences in the service-line specific geometric mean between (1) high- and low-cost (below the 75th percentile) hospitalizations and (2) fungal versus other types of peritonitis. Wage-adjusted hospitalization charges were converted to estimated costs using reported cost-to-charge ratios to estimate the cost of hospitalization. RESULTS: High-cost hospitalizations were associated with the following: age 3-12 years, Hispanic ethnicity, intensive care unit (ICU) stay, length of stay (LOS), and fungal peritonitis. Whereas absolute standardized cost by service line was significantly different when comparing high- and low-cost hospitalizations, the percentage of total cost by service line was similar in the two groups. Cost per case for fungal peritonitis was higher (p < 0.001) in every service line except pharmacy when compared to other peritonitis cases. The median (IQR) cost of hospitalization for the treatment of peritonitis was $13,655 ($7871, $28434) USD. CONCLUSIONS: Hospitalization-related costs for peritonitis treatment are substantial and arise from a variety of service lines. Fungal peritonitis is associated with high-cost hospitalization.
BACKGROUND: Although peritonitis causes significant morbidity and mortality in children receiving chronic peritoneal dialysis (CPD), little is known about costs associated with treatment. METHODS: We analyzed 246 peritonitis-related hospitalizations in the USA, linked by the Standardized Care to Improve Outcomes in Pediatric End Stage Renal Disease (SCOPE) and Pediatric Health Information Systems (PHIS) databases. Multivariable logistic regression was used to assess the relationship between high-cost hospitalizations (at or above the 75th percentile) and patient characteristics. Multivariable modeling was used to assess differences in the service-line specific geometric mean between (1) high- and low-cost (below the 75th percentile) hospitalizations and (2) fungal versus other types of peritonitis. Wage-adjusted hospitalization charges were converted to estimated costs using reported cost-to-charge ratios to estimate the cost of hospitalization. RESULTS: High-cost hospitalizations were associated with the following: age 3-12 years, Hispanic ethnicity, intensive care unit (ICU) stay, length of stay (LOS), and fungal peritonitis. Whereas absolute standardized cost by service line was significantly different when comparing high- and low-cost hospitalizations, the percentage of total cost by service line was similar in the two groups. Cost per case for fungal peritonitis was higher (p < 0.001) in every service line except pharmacy when compared to other peritonitis cases. The median (IQR) cost of hospitalization for the treatment of peritonitis was $13,655 ($7871, $28434) USD. CONCLUSIONS: Hospitalization-related costs for peritonitis treatment are substantial and arise from a variety of service lines. Fungal peritonitis is associated with high-cost hospitalization.
Entities:
Keywords:
Cost-to-charge ratio; Direct cost; Pediatric peritonitis; Peritoneal dialysis-related infection; Service line; Wage-adjusted charges
Authors: F Schaefer; R Feneberg; N Aksu; O Donmez; B Sadikoglu; S R Alexander; S Mir; I S Ha; M Fischbach; E Simkova; A R Watson; K Möller; H von Baum; B A Warady Journal: Kidney Int Date: 2007-09-19 Impact factor: 10.612
Authors: Alicia M Neu; Troy Richardson; John Lawlor; Jayne Stuart; Jason Newland; Nancy McAfee; Bradley A Warady Journal: Kidney Int Date: 2016-04-13 Impact factor: 10.612
Authors: P C Coyte; L G Young; B L Tipper; V M Mitchell; P R Stoffman; J Willumsen; D F Geary Journal: Am J Kidney Dis Date: 1996-04 Impact factor: 8.860