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Ureteropelvic junction obstruction
John S Lam1, Alberto Breda, Peter G Schulam
1Department of Urology, David Geffen School of Medicine at University of California-Los Angeles, Los Angeles, California 90095-1738, USA. jlam@mednet.ucla.edu
Insights
Ureteropelvic junction obstruction (UPJO) burden in the US shows decreasing hospitalizations in children, with a trend towards conservative management. Healthcare resource use and economic impact were analyzed.
Area of Science:
- Urology
- Health Economics
- Pediatric Surgery
Background:
- Ureteropelvic junction obstruction (UPJO) is a common congenital anomaly.
- Understanding UPJO's impact on healthcare resources is crucial for resource allocation and policy development.
Purpose of the Study:
- To quantify the burden of ureteropelvic junction obstruction (UPJO) in the United States.
- To identify trends in healthcare resource utilization for UPJO.
- To estimate the economic impact of UPJO.
Main Methods:
- Analysis of inpatient hospitalization data and physician office visits.
- Focus on trends from 1994 to 2003.
- Calculation of hospitalization rates, length of stay, and costs.
Main Results:
- Inpatient hospitalization rates for UPJO decreased from 1.1 to 0.8 per 100,000 between 1994 and 2000, primarily affecting children under 3 years.
- Physician office visits for Medicare beneficiaries remained stable.
- Average inpatient length of stay and cost per child were 2.9 days and $7,728 respectively (1999-2003), with total inpatient spending around $12 million annually.
Conclusions:
- Most ureteropelvic junction obstructions are diagnosed perinatally.
- Surgical intervention for pediatric UPJO has declined, with a rise in conservative management.
- UPJO management trends indicate a shift towards less invasive approaches in pediatric cases.
Purpose:
We quantified the burden of ureteropelvic junction obstruction in the United States by identifying trends in the use of health care resources and estimating the economic impact of the disease.
Materials And Methods:
The analytical methods used to generate these results were described previously.
Results:
Inpatient hospitalization rates were highest in children younger than 3 years. Most patients were male and hospitalizations occurred almost exclusively at urban centers. Patients with a primary diagnosis of ureteropelvic junction obstruction between 1994 and 2000 had an overall decrease in the age adjusted rate of inpatient hospitalization from 1.1/100,000 to 0.8/100,000. Physician office visits by Medicare beneficiaries with ureteropelvic junction obstruction as the primary diagnosis showed stable overall age adjusted rates during the reported years. Between 1999 and 2003 mean inpatient length of stay and cost per child hospitalized with the primary diagnosis of ureteropelvic junction obstruction was 2.9 days and $7,728, respectively. Average length of stay decreased more for children than for adults but total inpatient spending remained stable at about $12 million.
Conclusions:
The majority of ureteropelvic junction obstructions are diagnosed in the perinatal period. Surgical intervention for pediatric patients has decreased with time, while there has been an increasing trend toward the conservative management of this condition.
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