1. The cost of hospitalizations for treatment of hemodialysis catheter-associated blood stream infections in children: a retrospective cohort study
- Author
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Wasik, Heather L., Neu, Alicia, Warady, Bradley, Crawford, Brendan, Richardson, Troy, De Souza, Heidi G., and Cardwell, Diana
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Children -- Diseases ,Medical care, Cost of -- Evaluation ,Infection in children -- Care and treatment -- Patient outcomes ,Infection -- Care and treatment -- Patient outcomes ,Hemodialysis -- Complications and side effects -- Patient outcomes ,Health - Abstract
Background Hospitalization costs for treatment of hemodialysis (HD) catheter-associated blood stream infections (CA-BSI) in adults are high. No studies have evaluated hospitalization costs for HD CA-BSI in children or identified factors associated with high-cost hospitalizations. Methods We analyzed 160 HD CA-BSIs from the Standardizing Care to Improve Outcomes in Pediatric End-stage Kidney Disease (SCOPE) collaborative database linked to hospitalization encounters in the Pediatric Health Information System (PHIS) database. Charge-to-cost ratios were used to convert hospitalization charges reported in PHIS database to estimated hospital costs. Generalized linear mixed modeling was used to assess the relationship between higher-cost hospitalization (cost above 50.sup.th percentile) and patient and clinical characteristics. Generalized linear regression models were used to assess differences in mean service line costs between higher- and lower-cost hospitalizations. Results The median (IQR) length of stay for HD CA-BSI hospitalization was 5 (3-10) days. The median (IQR) cost for HD CA-BSI hospitalization was $18,375 ($11,584-$36,266). ICU stay (aOR 5.44, 95% CI 1.62-18.26, p = 0.01) and need for a catheter procedure (aOR = 6.08, 95% CI 2.45-15.07, p < 0.001) were associated with higher-cost hospitalization. Conclusions Hospitalizations for HD CA-BSIs in children are often multiple days and are associated with substantial costs. Interventions to reduce CA-BSI may reduce hospitalization costs for children who receive chronic HD. Graphical abstract, Author(s): Heather L. Wasik [sup.1] , Alicia Neu [sup.2] , Bradley Warady [sup.3] , Brendan Crawford [sup.4] , Troy Richardson [sup.5] , Heidi G. De Souza [sup.5] , Diana Cardwell [...]
- Published
- 2023
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