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Hospital factors associated with higher costs in pediatric blunt abdominal trauma: A national study.
Tessler, Robert A; Graves, Janessa M; Vavilala, Monica S; Goldin, Adam; Rivara, Frederick P.
Afiliación
  • Tessler RA; University of Washington, Harborview Injury Prevention and Research Center, 401 Broadway, 4(th) floor, Seattle, WA 98122; University of Pittsburgh, Department of Surgery UPMC Presbyterian Hospital, F1281, 200 Lothrop St., Pittsburgh, PA, 15213. Electronic address: rtessler@uw.edu.
  • Graves JM; Washington State University College of Nursing, 103 E Spokane Falls Blvd, Spokane, WA 99202; Washington State University, Community Health Analytics Project (CHAP) Washington State University, Pullman, WA. Electronic address: janessa.graves@wsu.edu.
  • Vavilala MS; University of Washington, Harborview Injury Prevention and Research Center, 401 Broadway, 4(th) floor, Seattle, WA 98122; University of Washington Department of Anesthesiology and Pain Medicine, 1959 NE Pacific Street, BB-1468, Seattle, WA 98195; University of Washington, Department of Pediatrics, 1
  • Goldin A; Seattle Children's Hospital, Division of General and Thoracic Surgery, 4800 Sand Point Way NE, Seattle, WA 98105. Electronic address: adam.goldin@seattlechildrens.org.
  • Rivara FP; University of Washington, Harborview Injury Prevention and Research Center, 401 Broadway, 4(th) floor, Seattle, WA 98122; University of Washington, Department of Pediatrics, 1959 NE Pacific Street, Box 356320, Seattle, WA 98105. Electronic address: fpr@uw.edu.
J Pediatr Surg ; 54(8): 1621-1627, 2019 Aug.
Article en En | MEDLINE | ID: mdl-30773396
BACKGROUND/PURPOSE: Our objective was to evaluate hospital factors, including children's hospital status, associated with higher costs for blunt solid organ pediatric abdominal trauma. METHODS: We queried the 2012 Healthcare Cost and Utilization Project (HCUP) Kid's Inpatient Database (KID) for patients 18 years or younger with low-grade and high-grade blunt abdominal trauma. We calculated total hospital costs and adjusted cost ratios (CR) controlling for patient and hospital-level characteristics. RESULTS: The 2012 KID included 882 low-grade and 222 high-grade pediatric abdominal trauma patients. Median (interquartile range) per hospitalization costs were similar at children's and nonchildren's hospitals for both low-grade (children's = $6575 [$4333-$10,862], nonchildren's $7027 [$4230-$12,219] p = 0.47) and high-grade (children's = $10,984 [$6211- $20,007] nonchildren's $10,156 [$5439-$18,404] p = 0.55) groups. Adjusted cost ratios demonstrated higher costs in the West and among investor owned hospitals for low-grade and high-grade injuries, respectively. Costs at rural hospitals were higher in both groups (low-grade CR = 2.35 95% CI 2.02, 2.74, high-grade CR = 2.78 95% CI 2.13, 3.63) compared to urban teaching hospitals. Cost ratios did not differ based on children's hospital status. CONCLUSION: Hospital costs were similar for children's and nonchildren's hospitals caring for pediatric abdominal trauma. Costs at rural hospitals are higher and may suggest financial instability or nonstandardized care of pediatric trauma patients. LEVEL OF EVIDENCE: III.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Heridas no Penetrantes / Costos de Hospital / Traumatismos Abdominales Tipo de estudio: Health_economic_evaluation / Risk_factors_studies Límite: Adolescent / Child / Child, preschool / Female / Humans / Infant / Male / Newborn País/Región como asunto: America do norte Idioma: En Revista: J Pediatr Surg Año: 2019 Tipo del documento: Article Pais de publicación: Estados Unidos
Texto completo
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Heridas no Penetrantes / Costos de Hospital / Traumatismos Abdominales Tipo de estudio: Health_economic_evaluation / Risk_factors_studies Límite: Adolescent / Child / Child, preschool / Female / Humans / Infant / Male / Newborn País/Región como asunto: America do norte Idioma: En Revista: J Pediatr Surg Año: 2019 Tipo del documento: Article Pais de publicación: Estados Unidos