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Inpatient health care utilization in the United States among children, adolescents, and young adults with nephrotic syndrome.
Am J Kidney Dis. 2013 Jun; 61(6):910-7.AJ

Abstract

BACKGROUND

Data describing inpatient health care utilization in children with nephrotic syndrome and related severe complications are limited. Our goals were to describe the charges, length of stay (LOS), and number of hospitalizations among children, adolescents, and young adults with nephrotic syndrome.

STUDY DESIGN

A cross-sectional analysis of the Kids' Inpatient Database (KID) database from the Healthcare Cost and Utilization Project (HCUP). The HCUP-KID is an all-payer database of hospital discharges for children, adolescents, and young adults in the United States compiled every 3 years by the Agency for Healthcare Research and Quality.

SETTING & PARTICIPANTS

HCUP-KID data were obtained for the 2006 and 2009 cohort years. We identified patients by searching discharges for nephrotic syndrome International Classification of Diseases, Ninth Revision, Clinical Modification diagnosis codes.

PREDICTOR

Patient demographics, disease complications in children, adolescents, and young adults hospitalized with nephrotic syndrome.

OUTCOME

Number of hospitalizations, mean charges, and LOS for children, adolescents, and young adults hospitalized with nephrotic syndrome.

RESULTS

There were 6,308 hospitalization discharges in children, adolescents, and young adults with a primary or secondary diagnosis of nephrotic syndrome reported by 38 and 44 states in 2006 and 2009, respectively, representing an estimated 9,934 discharges nationally. Nephrotic syndrome resulted in an estimated 48,700 inpatient days and charges totaling $259 million. The mean charge per hospitalization was ∼$26,500 (SE, $1,100) and LOS was 5 days (SE, 0.1). 16% of discharges for nephrotic syndrome had a diagnosis code for at least one severe complication, including thromboembolism (3.6%), septicemia (3.8%), peritonitis (2.6%), pneumonia (5.4%), or diabetes (2.4%). Multivariable analysis showed age 15 years or older, race, higher socioeconomic status, acute renal failure, thromboembolic disease, hypertension, and infections predicted higher mean hospitalization charges.

LIMITATIONS

The HCUP-KID database collects data on a hospitalization level. Consequently, health care utilization on an individual patient level or in the outpatient environment is not possible.

CONCLUSIONS

We present a comprehensive description of inpatient health care utilization in children, adolescents, and young adults with nephrotic syndrome. The complications of nephrotic syndrome, including thromboembolism, infection, and hypertension, contribute significantly to these charges.

Authors+Show Affiliations

Division of Pediatric Nephrology, Department of Pediatrics, School of Public Health, University of Michigan, Ann Arbor, MI, USA.No affiliation info availableNo 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, Non-U.S. Gov't

Language

eng

PubMed ID

23434062

Citation

Gipson, Debbie S., et al. "Inpatient Health Care Utilization in the United States Among Children, Adolescents, and Young Adults With Nephrotic Syndrome." American Journal of Kidney Diseases : the Official Journal of the National Kidney Foundation, vol. 61, no. 6, 2013, pp. 910-7.
Gipson DS, Messer KL, Tran CL, et al. Inpatient health care utilization in the United States among children, adolescents, and young adults with nephrotic syndrome. Am J Kidney Dis. 2013;61(6):910-7.
Gipson, D. S., Messer, K. L., Tran, C. L., Herreshoff, E. G., Samuel, J. P., Massengill, S. F., Song, P., & Selewski, D. T. (2013). Inpatient health care utilization in the United States among children, adolescents, and young adults with nephrotic syndrome. American Journal of Kidney Diseases : the Official Journal of the National Kidney Foundation, 61(6), 910-7. https://doi.org/10.1053/j.ajkd.2012.12.025
Gipson DS, et al. Inpatient Health Care Utilization in the United States Among Children, Adolescents, and Young Adults With Nephrotic Syndrome. Am J Kidney Dis. 2013;61(6):910-7. PubMed PMID: 23434062.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Inpatient health care utilization in the United States among children, adolescents, and young adults with nephrotic syndrome. AU - Gipson,Debbie S, AU - Messer,Kassandra L, AU - Tran,Cheryl L, AU - Herreshoff,Emily G, AU - Samuel,Joyce P, AU - Massengill,Susan F, AU - Song,Peter, AU - Selewski,David T, Y1 - 2013/02/20/ PY - 2012/06/23/received PY - 2012/12/22/accepted PY - 2013/2/26/entrez PY - 2013/2/26/pubmed PY - 2013/7/10/medline SP - 910 EP - 7 JF - American journal of kidney diseases : the official journal of the National Kidney Foundation JO - Am J Kidney Dis VL - 61 IS - 6 N2 - BACKGROUND: Data describing inpatient health care utilization in children with nephrotic syndrome and related severe complications are limited. Our goals were to describe the charges, length of stay (LOS), and number of hospitalizations among children, adolescents, and young adults with nephrotic syndrome. STUDY DESIGN: A cross-sectional analysis of the Kids' Inpatient Database (KID) database from the Healthcare Cost and Utilization Project (HCUP). The HCUP-KID is an all-payer database of hospital discharges for children, adolescents, and young adults in the United States compiled every 3 years by the Agency for Healthcare Research and Quality. SETTING & PARTICIPANTS: HCUP-KID data were obtained for the 2006 and 2009 cohort years. We identified patients by searching discharges for nephrotic syndrome International Classification of Diseases, Ninth Revision, Clinical Modification diagnosis codes. PREDICTOR: Patient demographics, disease complications in children, adolescents, and young adults hospitalized with nephrotic syndrome. OUTCOME: Number of hospitalizations, mean charges, and LOS for children, adolescents, and young adults hospitalized with nephrotic syndrome. RESULTS: There were 6,308 hospitalization discharges in children, adolescents, and young adults with a primary or secondary diagnosis of nephrotic syndrome reported by 38 and 44 states in 2006 and 2009, respectively, representing an estimated 9,934 discharges nationally. Nephrotic syndrome resulted in an estimated 48,700 inpatient days and charges totaling $259 million. The mean charge per hospitalization was ∼$26,500 (SE, $1,100) and LOS was 5 days (SE, 0.1). 16% of discharges for nephrotic syndrome had a diagnosis code for at least one severe complication, including thromboembolism (3.6%), septicemia (3.8%), peritonitis (2.6%), pneumonia (5.4%), or diabetes (2.4%). Multivariable analysis showed age 15 years or older, race, higher socioeconomic status, acute renal failure, thromboembolic disease, hypertension, and infections predicted higher mean hospitalization charges. LIMITATIONS: The HCUP-KID database collects data on a hospitalization level. Consequently, health care utilization on an individual patient level or in the outpatient environment is not possible. CONCLUSIONS: We present a comprehensive description of inpatient health care utilization in children, adolescents, and young adults with nephrotic syndrome. The complications of nephrotic syndrome, including thromboembolism, infection, and hypertension, contribute significantly to these charges. SN - 1523-6838 UR - https://www.unboundmedicine.com/medline/citation/23434062/Inpatient_health_care_utilization_in_the_United_States_among_children_adolescents_and_young_adults_with_nephrotic_syndrome_ DB - PRIME DP - Unbound Medicine ER -