Resource utilization and costs associated with the diagnostic evaluation of nonrefluxing primary hydronephrosis in infants

Ardavan Akhavan, Margarett Shnorhavorian, Louis P. Garrison, Paul A. Merguerian

Research output: Contribution to journalArticle

Abstract

Purpose Long-term evaluation of postnatal nonrefluxing primary hydronephrosis presents a dilemma for urologists since most cases resolve without surgery. We report longitudinal resource utilization and costs associated with diagnostic evaluation of infants with isolated primary nonrefluxing hydronephrosis to determine the costs associated with diagnosing a surgical case, and we assess the implications using a cost-consequences analysis. Materials and Methods A retrospective chart review was used to capture resource utilization for all patients younger than 6 months with hydronephrosis evaluated at our institution during a 5-year period. Infants with confounding urological diagnoses were excluded. Payer and societal perspectives were used. Costs were estimated from resource utilization, including radiographic imaging and clinical encounter types. Data were collected from first clinic visit until surgery or resolution or 3 years, whichever was shortest. Results Of 165 included patients surgical rates for hydronephrosis were 0% for grade I, 5% for grade II, 21% for grade III and 74% for grade IV. Median respective costs of identifying a single surgical case per increasing hydronephrosis grade 0 to IV were infinite, $37,600, $11,741 and $2,124 (p

Original languageEnglish (US)
Pages (from-to)919-924
Number of pages6
JournalJournal of Urology
Volume192
Issue number3
DOIs
StatePublished - 2014
Externally publishedYes

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Hydronephrosis
Costs and Cost Analysis
Ambulatory Care

Keywords

  • costs and cost analysis
  • diagnosis
  • health care economics and organizations
  • hydronephrosis
  • ureteral obstruction

ASJC Scopus subject areas

  • Urology

Cite this

Resource utilization and costs associated with the diagnostic evaluation of nonrefluxing primary hydronephrosis in infants. / Akhavan, Ardavan; Shnorhavorian, Margarett; Garrison, Louis P.; Merguerian, Paul A.

In: Journal of Urology, Vol. 192, No. 3, 2014, p. 919-924.

Research output: Contribution to journalArticle

Akhavan, Ardavan ; Shnorhavorian, Margarett ; Garrison, Louis P. ; Merguerian, Paul A. / Resource utilization and costs associated with the diagnostic evaluation of nonrefluxing primary hydronephrosis in infants. In: Journal of Urology. 2014 ; Vol. 192, No. 3. pp. 919-924.
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