Felicia Skelton1, Jason L Salemi2, Lois Akpati3, Sused Silva3, Deepa Dongarwar2, Barbara W Trautner4, Hamisu M Salihu2. 1. Center for Innovations in Quality, Effectiveness and Safety, Michael E. DeBakey VA Medical Center, Houston, Texas, the United States; H. Ben Taub Department of Physical Medicine and Rehabilitation, Baylor College of Medicine, Houston, Texas, the United States. Electronic address: skelton@bcm.edu. 2. Baylor College of Medicine Center of Excellence in Health Equity, Training, and Research, Houston, Texas, the United States. 3. Department of Biology, St. Thomas University, Houston, Texas, the United States. 4. Center for Innovations in Quality, Effectiveness and Safety, Michael E. DeBakey VA Medical Center, Houston, Texas, the United States; Infectious Disease Section, Department of Medicine, Baylor College of Medicine, Houston, Texas, the United States.
Abstract
OBJECTIVES: To determine the rates of emergency department (ED) visits and inpatient hospitalizations for genitourinary (GU) complications after spinal cord injury (SCI) using a national sample; to examine which patient and facility factors are associated with inhospital mortality; and to estimate direct medical costs of GU complications after SCI. DESIGN: Retrospective cross-sectional and cost analysis of the 2006 to 2015 National Inpatient Sample and National Emergency Department Sample from the Healthcare Cost and Utilization Project. PARTICIPANTS: SCI-related encounters using various International Classification of Disease, Ninth Edition, Clinical Modification diagnosis codes. The inpatient sample included 1,796,624 hospitalizations, and the ED sample included 618,118 treat-and-release visits. MAIN OUTCOME MEASURES: The exposure included a GU complication, identified by International Classification of Disease, Ninth Edition, Clinical Modification codes 590-599. The outcomes then included an ED visit or hospitalization, death prior to discharge, and direct medical costs estimated from reported hospital charges. RESULTS: For the inpatient sample, we observed a 2.5% annual increase (95% confidence interval [CI], 1.8-3.2) in the proportion of SCI-related hospitalizations with any GU complication from 2006 to 2011, and a lesser rate of increase of 0.9% (95% CI, 0.4-1.4) each year from 2011 to 2015. Age, level of injury, and payer source were correlated to inhospital mortality. The costs of GU-related health care use exceeded $4 billion over the study period. CONCLUSIONS: This study shows the rates and economic burden of health care use associated with GU complications in persons with SCI in the United States. The need to develop strategies to effectively deliver health care to the SCI population for these conditions remains great. Published by Elsevier Inc.
OBJECTIVES: To determine the rates of emergency department (ED) visits and inpatient hospitalizations for genitourinary (GU) complications after spinal cord injury (SCI) using a national sample; to examine which patient and facility factors are associated with inhospital mortality; and to estimate direct medical costs of GU complications after SCI. DESIGN: Retrospective cross-sectional and cost analysis of the 2006 to 2015 National Inpatient Sample and National Emergency Department Sample from the Healthcare Cost and Utilization Project. PARTICIPANTS: SCI-related encounters using various International Classification of Disease, Ninth Edition, Clinical Modification diagnosis codes. The inpatient sample included 1,796,624 hospitalizations, and the ED sample included 618,118 treat-and-release visits. MAIN OUTCOME MEASURES: The exposure included a GU complication, identified by International Classification of Disease, Ninth Edition, Clinical Modification codes 590-599. The outcomes then included an ED visit or hospitalization, death prior to discharge, and direct medical costs estimated from reported hospital charges. RESULTS: For the inpatient sample, we observed a 2.5% annual increase (95% confidence interval [CI], 1.8-3.2) in the proportion of SCI-related hospitalizations with any GU complication from 2006 to 2011, and a lesser rate of increase of 0.9% (95% CI, 0.4-1.4) each year from 2011 to 2015. Age, level of injury, and payer source were correlated to inhospital mortality. The costs of GU-related health care use exceeded $4 billion over the study period. CONCLUSIONS: This study shows the rates and economic burden of health care use associated with GU complications in persons with SCI in the United States. The need to develop strategies to effectively deliver health care to the SCI population for these conditions remains great. Published by Elsevier Inc.
Authors: Felicia Skelton-Dudley; James Doan; Katie Suda; S Ann Holmes; Charlesnika Evans; Barbara Trautner Journal: Top Spinal Cord Inj Rehabil Date: 2019
Authors: Jennifer A Locke; Blayne Welk; Andrew Macnab; Carly S Rivers; Dilnur Kurban; Mark Nigro; Lynn Stothers Journal: Spinal Cord Date: 2019-07-09 Impact factor: 2.772
Authors: Felicia Skelton; Sarah May; Larissa Grigoryan; Ivy Poon; Sally Ann Holmes; Lindsey Martin; Barbara W Trautner Journal: PM R Date: 2020-05-13 Impact factor: 2.298
Authors: Belkys C Sanchez; Emmaline R Heckmann; Sabrina I Green; Justin R Clark; Heidi B Kaplan; Robert F Ramig; Casey Hines-Munson; Felicia Skelton; Barbara W Trautner; Anthony W Maresso Journal: Front Microbiol Date: 2022-05-10 Impact factor: 6.064
Authors: Casey Hines-Munson; Sarah May; Ivy Poon; S Ann Holmes; Lindsey Martin; Barbara W Trautner; Felicia Skelton Journal: PM R Date: 2021-07-22 Impact factor: 2.298