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., Cardwell, Diana, and Ruebner, Rebecca
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LENGTH of stay in hospitals , *INTENSIVE care units , *CATHETER-related infections , *CONFIDENCE intervals , *MEDICAL care costs , *RETROSPECTIVE studies , *ACQUISITION of data , *REGRESSION analysis , *HOSPITAL care , *MEDICAL records , *DESCRIPTIVE statistics , *HEMODIALYSIS , *CENTRAL venous catheters , *BLOODBORNE infections , *LONGITUDINAL method , *CHILDREN , *ADOLESCENCE - 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 50th 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. [ABSTRACT FROM AUTHOR]
- Published
- 2023
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