Analysis of Healthcare Institutional Costs of Pediatric Home Parenteral Nutrition Central Line Infections.
J Pediatr Gastroenterol Nutr
; 67(4): e77-e81, 2018 10.
Article
en En
| MEDLINE
| ID: mdl-29912033
ABSTRACT
BACKGROUND:
Although previous literature suggests home parenteral nutrition (HPN)-dependent children experience frequent complications like community-acquired central line-associated bloodstream infections (CLABSI), few studies have characterized the cost.OBJECTIVE:
The aim of this study was to evaluate institutional cost of community-acquired CLABSI in pediatric patients with HPN.METHODS:
This is a single-center retrospective review of institutional costs for patients with HPN with community-acquired CLABSI at a tertiary care children's hospital. Inclusion was age 18 years or less between October 2011 and April 2016. Exclusions were death during hospitalization and readmission within 2 days of discharge. Patient-level factors were compared between high-cost group and all others using Welch 2-sample t test and analysis of variance. Multivariable logistic regression was used to determine predictors of higher cost.RESULTS:
There were 176 CLABSI admissions among 68 patients during the study period (median 2 hospitalizations per patients). The mean cost and length of stay per hospital admission are $28,375 (2015 US dollars) and 8 days, and both were associated with intensive care unit admission (ICU), central venous catheter removal, private insurance, and age <2 years at admission. Nine percent of patients were classified as "super-utilizers" whose 54 hospitalizations accounted for 28% of total institutional costs.CONCLUSIONS:
Among pediatric patients with HPN, community-acquired CLABSI is associated with significant cost and length of stay. Healthcare utilization is disproportionately concentrated in a small number of patients. These study findings may help inform cost analysis for future CLABSI prevention strategies.
Texto completo:
1
Base de datos:
MEDLINE
Asunto principal:
Costos de la Atención en Salud
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Nutrición Parenteral en el Domicilio
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Infecciones Comunitarias Adquiridas
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Infecciones Relacionadas con Catéteres
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Centros de Atención Terciaria
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Hospitales Pediátricos
Tipo de estudio:
Health_economic_evaluation
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Observational_studies
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Prognostic_studies
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Risk_factors_studies
Idioma:
En
Revista:
J Pediatr Gastroenterol Nutr
Año:
2018
Tipo del documento:
Article