Continence in the cloacal exstrophy patient: What does it cost?

Seth D. Goldstein, Brian M. Inouye, Sunil Reddy, Kathy Lue, Ezekiel E. Young, Mahmoud Abdelwahab, Mehnaj Grewal, Spencer Wildonger, Andrew A. Stec, John Phillip Gearhart

Research output: Contribution to journalArticle

Abstract

Background: Surgical advancements have made cloacal exstrophy (CE) a survivable condition, though management remains complex. Urologic, orthopedic, colorectal and gynecologic interventions are not standardized, and the cost of this care is high. While the importance of a successful primary closure in terms of outcomes is known, the economic consequences of failure remain uncharacterized. Methods: A prospectively maintained institutional database of epispadias-exstrophy complex patients was reviewed for continent CE patients. Hospital charges for all inpatient admissions prior to achieving urinary continence were inflation-adjusted to year 2013 values using Consumer Price Index for medical care published by the United States Bureau of Labor Statistics. Records for which charge data were incomplete were completed by using single mean imputation, also inflation-adjusted. Descriptive data are presented as mean. ±. standard deviation (SD). Results: Of 102 CE patients, 35 had available hospital charge data: 15 who underwent successful primary closure at the authors' institution and 20 who presented after previously failed primary closures at referring institutions. The mean. ±. SD hospital charges for primary closure in the success group were $136,201. ±. $48,920. These patients then underwent subsequent additional surgeries that accrued charges of $59,549. ±. $25,189 in order to achieve continence. Overall, successful primary closures accumulated hospital charges of $200,366. ±. $40,071. In comparison, patients referred after prior failure required significantly more hospital admissions and additional charges of $207,674. ±. $65,820 were required to achieve continence (p.

Original languageEnglish (US)
JournalJournal of Pediatric Surgery
DOIs
StateAccepted/In press - Jun 9 2015

Fingerprint

Hospital Charges
Costs and Cost Analysis
Economic Inflation
Epispadias
Economics
Orthopedics
Inpatients
Databases

Keywords

  • Cloacal exstrophy
  • Continence
  • Cost analysis

ASJC Scopus subject areas

  • Surgery
  • Pediatrics, Perinatology, and Child Health

Cite this

Goldstein, S. D., Inouye, B. M., Reddy, S., Lue, K., Young, E. E., Abdelwahab, M., ... Gearhart, J. P. (Accepted/In press). Continence in the cloacal exstrophy patient: What does it cost? Journal of Pediatric Surgery. https://doi.org/10.1016/j.jpedsurg.2015.12.003

Continence in the cloacal exstrophy patient : What does it cost? / Goldstein, Seth D.; Inouye, Brian M.; Reddy, Sunil; Lue, Kathy; Young, Ezekiel E.; Abdelwahab, Mahmoud; Grewal, Mehnaj; Wildonger, Spencer; Stec, Andrew A.; Gearhart, John Phillip.

In: Journal of Pediatric Surgery, 09.06.2015.

Research output: Contribution to journalArticle

Goldstein, SD, Inouye, BM, Reddy, S, Lue, K, Young, EE, Abdelwahab, M, Grewal, M, Wildonger, S, Stec, AA & Gearhart, JP 2015, 'Continence in the cloacal exstrophy patient: What does it cost?', Journal of Pediatric Surgery. https://doi.org/10.1016/j.jpedsurg.2015.12.003
Goldstein, Seth D. ; Inouye, Brian M. ; Reddy, Sunil ; Lue, Kathy ; Young, Ezekiel E. ; Abdelwahab, Mahmoud ; Grewal, Mehnaj ; Wildonger, Spencer ; Stec, Andrew A. ; Gearhart, John Phillip. / Continence in the cloacal exstrophy patient : What does it cost?. In: Journal of Pediatric Surgery. 2015.
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