Factors associated with high-cost hospitalization for peritonitis in children receiving chronic peritoneal dialysis in the United States

on behalf of the SCOPE Investigators

Research output: Contribution to journalArticle

Abstract

Background: Although peritonitis causes significant morbidity and mortality in children receiving chronic peritoneal dialysis (CPD), little is known about costs associated with treatment. Methods: We analyzed 246 peritonitis-related hospitalizations in the USA, linked by the Standardized Care to Improve Outcomes in Pediatric End Stage Renal Disease (SCOPE) and Pediatric Health Information Systems (PHIS) databases. Multivariable logistic regression was used to assess the relationship between high-cost hospitalizations (at or above the 75th percentile) and patient characteristics. Multivariable modeling was used to assess differences in the service-line specific geometric mean between (1) high- and low-cost (below the 75th percentile) hospitalizations and (2) fungal versus other types of peritonitis. Wage-adjusted hospitalization charges were converted to estimated costs using reported cost-to-charge ratios to estimate the cost of hospitalization. Results: High-cost hospitalizations were associated with the following: age 3–12 years, Hispanic ethnicity, intensive care unit (ICU) stay, length of stay (LOS), and fungal peritonitis. Whereas absolute standardized cost by service line was significantly different when comparing high- and low-cost hospitalizations, the percentage of total cost by service line was similar in the two groups. Cost per case for fungal peritonitis was higher (p < 0.001) in every service line except pharmacy when compared to other peritonitis cases. The median (IQR) cost of hospitalization for the treatment of peritonitis was $13,655 ($7871, $28434) USD. Conclusions: Hospitalization-related costs for peritonitis treatment are substantial and arise from a variety of service lines. Fungal peritonitis is associated with high-cost hospitalization.

Original languageEnglish (US)
JournalPediatric Nephrology
DOIs
StateAccepted/In press - Jan 1 2019

Fingerprint

Peritoneal Dialysis
Peritonitis
Hospitalization
Costs and Cost Analysis
Health Care Costs
Pediatrics
Health Information Systems
Child Mortality
Salaries and Fringe Benefits
Hispanic Americans
Chronic Kidney Failure
Intensive Care Units
Length of Stay
Logistic Models

Keywords

  • Cost-to-charge ratio
  • Direct cost
  • Pediatric peritonitis
  • Peritoneal dialysis-related infection
  • Service line
  • Wage-adjusted charges

ASJC Scopus subject areas

  • Pediatrics, Perinatology, and Child Health
  • Nephrology

Cite this

Factors associated with high-cost hospitalization for peritonitis in children receiving chronic peritoneal dialysis in the United States. / on behalf of the SCOPE Investigators.

In: Pediatric Nephrology, 01.01.2019.

Research output: Contribution to journalArticle

@article{ec7cd088642e4b0babd8e8361c96ecfd,
title = "Factors associated with high-cost hospitalization for peritonitis in children receiving chronic peritoneal dialysis in the United States",
abstract = "Background: Although peritonitis causes significant morbidity and mortality in children receiving chronic peritoneal dialysis (CPD), little is known about costs associated with treatment. Methods: We analyzed 246 peritonitis-related hospitalizations in the USA, linked by the Standardized Care to Improve Outcomes in Pediatric End Stage Renal Disease (SCOPE) and Pediatric Health Information Systems (PHIS) databases. Multivariable logistic regression was used to assess the relationship between high-cost hospitalizations (at or above the 75th percentile) and patient characteristics. Multivariable modeling was used to assess differences in the service-line specific geometric mean between (1) high- and low-cost (below the 75th percentile) hospitalizations and (2) fungal versus other types of peritonitis. Wage-adjusted hospitalization charges were converted to estimated costs using reported cost-to-charge ratios to estimate the cost of hospitalization. Results: High-cost hospitalizations were associated with the following: age 3–12 years, Hispanic ethnicity, intensive care unit (ICU) stay, length of stay (LOS), and fungal peritonitis. Whereas absolute standardized cost by service line was significantly different when comparing high- and low-cost hospitalizations, the percentage of total cost by service line was similar in the two groups. Cost per case for fungal peritonitis was higher (p < 0.001) in every service line except pharmacy when compared to other peritonitis cases. The median (IQR) cost of hospitalization for the treatment of peritonitis was $13,655 ($7871, $28434) USD. Conclusions: Hospitalization-related costs for peritonitis treatment are substantial and arise from a variety of service lines. Fungal peritonitis is associated with high-cost hospitalization.",
keywords = "Cost-to-charge ratio, Direct cost, Pediatric peritonitis, Peritoneal dialysis-related infection, Service line, Wage-adjusted charges",
author = "{on behalf of the SCOPE Investigators} and {Redpath Mahon}, {Allison C.} and Troy Richardson and Neu, {Alicia M} and Warady, {Bradley A.}",
year = "2019",
month = "1",
day = "1",
doi = "10.1007/s00467-018-4183-0",
language = "English (US)",
journal = "Pediatric Nephrology",
issn = "0931-041X",
publisher = "Springer Verlag",

}

TY - JOUR

T1 - Factors associated with high-cost hospitalization for peritonitis in children receiving chronic peritoneal dialysis in the United States

AU - on behalf of the SCOPE Investigators

AU - Redpath Mahon, Allison C.

AU - Richardson, Troy

AU - Neu, Alicia M

AU - Warady, Bradley A.

PY - 2019/1/1

Y1 - 2019/1/1

N2 - Background: Although peritonitis causes significant morbidity and mortality in children receiving chronic peritoneal dialysis (CPD), little is known about costs associated with treatment. Methods: We analyzed 246 peritonitis-related hospitalizations in the USA, linked by the Standardized Care to Improve Outcomes in Pediatric End Stage Renal Disease (SCOPE) and Pediatric Health Information Systems (PHIS) databases. Multivariable logistic regression was used to assess the relationship between high-cost hospitalizations (at or above the 75th percentile) and patient characteristics. Multivariable modeling was used to assess differences in the service-line specific geometric mean between (1) high- and low-cost (below the 75th percentile) hospitalizations and (2) fungal versus other types of peritonitis. Wage-adjusted hospitalization charges were converted to estimated costs using reported cost-to-charge ratios to estimate the cost of hospitalization. Results: High-cost hospitalizations were associated with the following: age 3–12 years, Hispanic ethnicity, intensive care unit (ICU) stay, length of stay (LOS), and fungal peritonitis. Whereas absolute standardized cost by service line was significantly different when comparing high- and low-cost hospitalizations, the percentage of total cost by service line was similar in the two groups. Cost per case for fungal peritonitis was higher (p < 0.001) in every service line except pharmacy when compared to other peritonitis cases. The median (IQR) cost of hospitalization for the treatment of peritonitis was $13,655 ($7871, $28434) USD. Conclusions: Hospitalization-related costs for peritonitis treatment are substantial and arise from a variety of service lines. Fungal peritonitis is associated with high-cost hospitalization.

AB - Background: Although peritonitis causes significant morbidity and mortality in children receiving chronic peritoneal dialysis (CPD), little is known about costs associated with treatment. Methods: We analyzed 246 peritonitis-related hospitalizations in the USA, linked by the Standardized Care to Improve Outcomes in Pediatric End Stage Renal Disease (SCOPE) and Pediatric Health Information Systems (PHIS) databases. Multivariable logistic regression was used to assess the relationship between high-cost hospitalizations (at or above the 75th percentile) and patient characteristics. Multivariable modeling was used to assess differences in the service-line specific geometric mean between (1) high- and low-cost (below the 75th percentile) hospitalizations and (2) fungal versus other types of peritonitis. Wage-adjusted hospitalization charges were converted to estimated costs using reported cost-to-charge ratios to estimate the cost of hospitalization. Results: High-cost hospitalizations were associated with the following: age 3–12 years, Hispanic ethnicity, intensive care unit (ICU) stay, length of stay (LOS), and fungal peritonitis. Whereas absolute standardized cost by service line was significantly different when comparing high- and low-cost hospitalizations, the percentage of total cost by service line was similar in the two groups. Cost per case for fungal peritonitis was higher (p < 0.001) in every service line except pharmacy when compared to other peritonitis cases. The median (IQR) cost of hospitalization for the treatment of peritonitis was $13,655 ($7871, $28434) USD. Conclusions: Hospitalization-related costs for peritonitis treatment are substantial and arise from a variety of service lines. Fungal peritonitis is associated with high-cost hospitalization.

KW - Cost-to-charge ratio

KW - Direct cost

KW - Pediatric peritonitis

KW - Peritoneal dialysis-related infection

KW - Service line

KW - Wage-adjusted charges

UR - http://www.scopus.com/inward/record.url?scp=85059508096&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=85059508096&partnerID=8YFLogxK

U2 - 10.1007/s00467-018-4183-0

DO - 10.1007/s00467-018-4183-0

M3 - Article

C2 - 30603809

AN - SCOPUS:85059508096

JO - Pediatric Nephrology

JF - Pediatric Nephrology

SN - 0931-041X

ER -