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Pediatrics. 2015 Sep;136(3):432-9. doi: 10.1542/peds.2015-1386. Epub 2015 Aug 10.

Costs of Venous Thromboembolism, Catheter-Associated Urinary Tract Infection, and Pressure Ulcer.

Author information

1
Center for Applied Research and Evaluation, Department of Pediatrics, College of Medicine, University of Arkansas for Medical Sciences, Little Rock, Arkansas; agoudie@uams.edu.
2
James M. Anderson Center for Health System Excellence, and Haile US Bank College of Business, Northern Kentucky University;
3
James M. Anderson Center for Health System Excellence, and Division of Hospital Medicine, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio;
4
Department of Pediatrics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania;
5
Nationwide Children's Hospital, Columbus, Ohio; and Division of Pediatric Critical Care Medicine, Department of Pediatrics, The Ohio State University College of Medicine, Columbus, Ohio.
6
James M. Anderson Center for Health System Excellence, and.

Abstract

OBJECTIVE:

To estimate differences in the length of stay (LOS) and costs for comparable pediatric patients with and without venous thromboembolism (VTE), catheter-associated urinary tract infection (CAUTI), and pressure ulcer (PU).

METHODS:

We identified at-risk children 1 to 17 years old with inpatient discharges in the Nationwide Inpatient Sample. We used a high dimensional propensity score matching method to adjust for case-mix at the patient level then estimated differences in the LOS and costs for comparable pediatric patients with and without VTE, CAUTI, and PU.

RESULTS:

Incidence rates were 32 (VTE), 130 (CAUTI), and 3 (PU) per 10 000 at-risk patient discharges. Patients with VTE had an increased 8.1 inpatient days (95% confidence interval [CI]: 3.9 to 12.3) and excess average costs of $27 686 (95% CI: $11 137 to $44 235) compared with matched controls. Patients with CAUTI had an increased 2.4 inpatient days (95% CI: 1.2 to 3.6) and excess average costs of $7200 (95% CI: $2224 to $12 176). No statistical differences were found between patients with and without PU.

CONCLUSIONS:

The significantly extended LOS highlights the substantial morbidity associated with these potentially preventable events. Hospitals seeking to develop programs targeting VTE and CAUTI should consider the improved turnover of beds made available by each event prevented.

PMID:
26260712
DOI:
10.1542/peds.2015-1386
[Indexed for MEDLINE]
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