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Hospital care for children with hydrocephalus in the United States: utilization, charges, comorbidities, and deaths.
J Neurosurg Pediatr. 2008 Feb; 1(2):131-7.JN

Abstract

OBJECT

The aims of this study were to measure inpatient health care for pediatric hydrocephalus in the US; describe patient, hospital, and hospitalization characteristics for pediatric hydrocephalus inpatient care; and determine characteristics associated with death.

METHODS

A cross-sectional study was performed using the 1997, 2000, and 2003 Healthcare Cost and Utilization Project Kids' Inpatient Databases (KID), nationally representative weighted data sets of hospital discharges for pediatric patients. A hydrocephalus-related hospitalization was classified as either cerebrospinal fluid (CSF) shunt-related (including initial placements, infections, malfunctions, or other) or non-CSF shunt-related. Patients>18 years of age were excluded. The KID provided weighted estimates of 6.657, 6.597, and 6.732 million total discharges in the 3 study years.

RESULTS

Each year there were 38,200-39,900 admissions, 391,000-433,000 hospital days, and total hospital charges of $1.4-2.0 billion for pediatric hydrocephalus. Hydrocephalus accounted for 0.6% of all pediatric hospital admissions in the US in 2003, but for 1.8% of all pediatric hospital days and 3.1% of all pediatric hospital charges. Over the study years, children admitted with hydrocephalus were older, had an increase in comorbidities, and were admitted more frequently to teaching hospitals. Compared with children who survived, those who died were more likely to be <3 months of age and have a birth-related admission, have no insurance, have comorbidities, be transferred, and have a non-CSF shunt-related admission.

CONCLUSIONS

Children with hydrocephalus have a chronic illness and use a disproportionate share of hospital days and healthcare dollars in the US. Since 1997 they have increased in age and in number of comorbid conditions. For important changes in morbidity and mortality rates to be made, focused research efforts and funding are necessary.

Authors+Show Affiliations

Department of Pediatrics, Division of Inpatient Medicine, University of Utah, Salt Lake City, Utah 84113, USA. Tamara.Simon@hsc.utah.eduNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Research Support, N.I.H., Extramural
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

18352782

Citation

Simon, Tamara D., et al. "Hospital Care for Children With Hydrocephalus in the United States: Utilization, Charges, Comorbidities, and Deaths." Journal of Neurosurgery. Pediatrics, vol. 1, no. 2, 2008, pp. 131-7.
Simon TD, Riva-Cambrin J, Srivastava R, et al. Hospital care for children with hydrocephalus in the United States: utilization, charges, comorbidities, and deaths. J Neurosurg Pediatr. 2008;1(2):131-7.
Simon, T. D., Riva-Cambrin, J., Srivastava, R., Bratton, S. L., Dean, J. M., & Kestle, J. R. (2008). Hospital care for children with hydrocephalus in the United States: utilization, charges, comorbidities, and deaths. Journal of Neurosurgery. Pediatrics, 1(2), 131-7. https://doi.org/10.3171/PED/2008/1/2/131
Simon TD, et al. Hospital Care for Children With Hydrocephalus in the United States: Utilization, Charges, Comorbidities, and Deaths. J Neurosurg Pediatr. 2008;1(2):131-7. PubMed PMID: 18352782.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Hospital care for children with hydrocephalus in the United States: utilization, charges, comorbidities, and deaths. AU - Simon,Tamara D, AU - Riva-Cambrin,Jay, AU - Srivastava,Raj, AU - Bratton,Susan L, AU - Dean,J Michael, AU - Kestle,John R W, AU - ,, PY - 2008/3/21/pubmed PY - 2008/5/9/medline PY - 2008/3/21/entrez SP - 131 EP - 7 JF - Journal of neurosurgery. Pediatrics JO - J Neurosurg Pediatr VL - 1 IS - 2 N2 - OBJECT: The aims of this study were to measure inpatient health care for pediatric hydrocephalus in the US; describe patient, hospital, and hospitalization characteristics for pediatric hydrocephalus inpatient care; and determine characteristics associated with death. METHODS: A cross-sectional study was performed using the 1997, 2000, and 2003 Healthcare Cost and Utilization Project Kids' Inpatient Databases (KID), nationally representative weighted data sets of hospital discharges for pediatric patients. A hydrocephalus-related hospitalization was classified as either cerebrospinal fluid (CSF) shunt-related (including initial placements, infections, malfunctions, or other) or non-CSF shunt-related. Patients>18 years of age were excluded. The KID provided weighted estimates of 6.657, 6.597, and 6.732 million total discharges in the 3 study years. RESULTS: Each year there were 38,200-39,900 admissions, 391,000-433,000 hospital days, and total hospital charges of $1.4-2.0 billion for pediatric hydrocephalus. Hydrocephalus accounted for 0.6% of all pediatric hospital admissions in the US in 2003, but for 1.8% of all pediatric hospital days and 3.1% of all pediatric hospital charges. Over the study years, children admitted with hydrocephalus were older, had an increase in comorbidities, and were admitted more frequently to teaching hospitals. Compared with children who survived, those who died were more likely to be <3 months of age and have a birth-related admission, have no insurance, have comorbidities, be transferred, and have a non-CSF shunt-related admission. CONCLUSIONS: Children with hydrocephalus have a chronic illness and use a disproportionate share of hospital days and healthcare dollars in the US. Since 1997 they have increased in age and in number of comorbid conditions. For important changes in morbidity and mortality rates to be made, focused research efforts and funding are necessary. SN - 1933-0707 UR - https://www.unboundmedicine.com/medline/citation/18352782/Hospital_care_for_children_with_hydrocephalus_in_the_United_States:_utilization_charges_comorbidities_and_deaths_ L2 - https://thejns.org/doi/10.3171/PED/2008/1/2/131 DB - PRIME DP - Unbound Medicine ER -