Tags

Type your tag names separated by a space and hit enter

Does hospital type affect pyloromyotomy outcomes? Analysis of the Kids' Inpatient Database.
Surgery. 2010 Aug; 148(2):411-9.S

Abstract

BACKGROUND

Pyloromyotomy is a common operative procedure performed on infants. The purpose of this study was to determine if hospital type affects lengths of stay (LOS), charges, and morbidity.

METHODS

Patients undergoing pyloromyotomy were identified in the Kids' Inpatients Database from 2000, 2003, and 2006. Freestanding children's hospitals (CH) were compared with children's units within general hospitals (CUGH) and general/nonchildren's hospitals (GH).

RESULTS

Of the 10,969 patients, 25% received care at 30 CH, 35% received care at 94 CUGH, and 40% received care at 662 GH. Adjusted LOS were 2.41 days for CH, 2.75 days for CUGH, and 2.82 days for GH (P < .01). Adjusted mean charges were $11,160 for CH, $12,284 for CUGH, and $10,197 for GH (P = .01). CH had the lowest unadjusted complication rate at 1.2% compared with 1.6% at CUGH and 2.2% at GH (P < .01). GH were more likely to have patients with prolonged LOS (> or =4 days) compared with CH after adjusting for patient and hospital factors (odds ratio [OR], 1.7; 95% confidence interval [CI], 1.2-2.5). After accounting for LOS, CUGH were more likely to have higher charges (> or =$11,057) compared with CH (OR, 3.4; 95% CI, 1.03-11.18). The adjusted mean charges rose from $7,733 in 2000 to $11,335 in 2003 and to $14,572 in 2006 (P < .01).

CONCLUSION

CH had the shortest LOS and lowest complication rates. Despite a higher complication rate and longer LOS, GH had the lowest charges. There is an opportunity to identify best practices, to improve quality, and to lower costs for pyloromyotomy in the United States, regardless of hospital type.

Authors+Show Affiliations

Division of Research and Optimal Patient Care, American College of Surgeons, Chicago, IL, USA. m-raval@md.northwestern.eduNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Research Support, Non-U.S. Gov't
Research Support, U.S. Gov't, Non-P.H.S.

Language

eng

PubMed ID

20553706

Citation

Raval, Mehul V., et al. "Does Hospital Type Affect Pyloromyotomy Outcomes? Analysis of the Kids' Inpatient Database." Surgery, vol. 148, no. 2, 2010, pp. 411-9.
Raval MV, Cohen ME, Barsness KA, et al. Does hospital type affect pyloromyotomy outcomes? Analysis of the Kids' Inpatient Database. Surgery. 2010;148(2):411-9.
Raval, M. V., Cohen, M. E., Barsness, K. A., Bentrem, D. J., Phillips, J. D., & Reynolds, M. (2010). Does hospital type affect pyloromyotomy outcomes? Analysis of the Kids' Inpatient Database. Surgery, 148(2), 411-9. https://doi.org/10.1016/j.surg.2010.04.015
Raval MV, et al. Does Hospital Type Affect Pyloromyotomy Outcomes? Analysis of the Kids' Inpatient Database. Surgery. 2010;148(2):411-9. PubMed PMID: 20553706.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Does hospital type affect pyloromyotomy outcomes? Analysis of the Kids' Inpatient Database. AU - Raval,Mehul V, AU - Cohen,Mark E, AU - Barsness,Katherine A, AU - Bentrem,David J, AU - Phillips,J Duncan, AU - Reynolds,Marleta, Y1 - 2010/05/31/ PY - 2010/01/19/received PY - 2010/04/16/accepted PY - 2010/6/18/entrez PY - 2010/6/18/pubmed PY - 2010/8/7/medline SP - 411 EP - 9 JF - Surgery JO - Surgery VL - 148 IS - 2 N2 - BACKGROUND: Pyloromyotomy is a common operative procedure performed on infants. The purpose of this study was to determine if hospital type affects lengths of stay (LOS), charges, and morbidity. METHODS: Patients undergoing pyloromyotomy were identified in the Kids' Inpatients Database from 2000, 2003, and 2006. Freestanding children's hospitals (CH) were compared with children's units within general hospitals (CUGH) and general/nonchildren's hospitals (GH). RESULTS: Of the 10,969 patients, 25% received care at 30 CH, 35% received care at 94 CUGH, and 40% received care at 662 GH. Adjusted LOS were 2.41 days for CH, 2.75 days for CUGH, and 2.82 days for GH (P < .01). Adjusted mean charges were $11,160 for CH, $12,284 for CUGH, and $10,197 for GH (P = .01). CH had the lowest unadjusted complication rate at 1.2% compared with 1.6% at CUGH and 2.2% at GH (P < .01). GH were more likely to have patients with prolonged LOS (> or =4 days) compared with CH after adjusting for patient and hospital factors (odds ratio [OR], 1.7; 95% confidence interval [CI], 1.2-2.5). After accounting for LOS, CUGH were more likely to have higher charges (> or =$11,057) compared with CH (OR, 3.4; 95% CI, 1.03-11.18). The adjusted mean charges rose from $7,733 in 2000 to $11,335 in 2003 and to $14,572 in 2006 (P < .01). CONCLUSION: CH had the shortest LOS and lowest complication rates. Despite a higher complication rate and longer LOS, GH had the lowest charges. There is an opportunity to identify best practices, to improve quality, and to lower costs for pyloromyotomy in the United States, regardless of hospital type. SN - 1532-7361 UR - https://www.unboundmedicine.com/medline/citation/20553706/Does_hospital_type_affect_pyloromyotomy_outcomes_Analysis_of_the_Kids'_Inpatient_Database_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S0039-6060(10)00210-2 DB - PRIME DP - Unbound Medicine ER -