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Routine admission urinalysis examination in pediatric patients: a poor value
- Source :
- Pediatrics. Sept, 1990, Vol. v86 Issue n3, p345, 5 p.
- Publication Year :
- 1990
-
Abstract
- Urinalysis or chemical analysis of the urine for various elements is considered to be an important screening method in children who are admitted to the hospital. The effectiveness of urinalysis in detecting urinary tract infections was assessed in children admitted to a hospital day-care unit or admitted overnight to medical or surgical services between June and November 1987. Urinalysis was essential for diagnosis or treatment in 543 of 2,695 children admitted to the hospital; these test results were not included in the study. Urinalysis was performed on 145 children admitted to the day-care unit and 587 inpatients (of the remaining 2,152 hospitalized children). Of the 732 urinalysis tests, the results were abnormal in 149 cases, including 23 percent of the children admitted overnight and 10 percent admitted to the day unit. The number of abnormal urinalysis tests was similar in surgical and medical inpatients. Urinalysis was effective in detecting pyuria or pus in the urine in 90 patients, hematuria or blood in the urine in 66 patients, and urinary tract infection in 6 patients. Follow-up tests were performed in 38 percent of the children with abnormal urinalysis results. Abnormalities persisted in 58 percent those who had additional urinalysis tests, although most subsequent abnormal results were not further investigated. The total cost of initial urinalysis and additional diagnostic studies of 732 patients over a two-month period was $23,465, with the cost for every diagnosis of urinary tract infection calculated at $3,911. These findings show that hospital bylaws requiring routine urinalysis upon admission are often ignored; unfortunately, the data also indicate that most abnormal results and repeated abnormal results are not further investigated. At this medical center, urinalysis was a costly screening test, which provided limited benefit in detecting kidney disease. (Consumer Summary produced by Reliance Medical Information, Inc.)
Details
- ISSN :
- 00314005
- Volume :
- v86
- Issue :
- n3
- Database :
- Gale General OneFile
- Journal :
- Pediatrics
- Publication Type :
- Academic Journal
- Accession number :
- edsgcl.8872072