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Trends in pediatric urolithiasis: patient characteristics, associated diagnoses, and financial burden
Kirsten Kusumi1, Brian Becknell, Andrew Schwaderer
1Division of Nephrology, Department of Pediatrics, Nationwide Children's Hospital/The Ohio State University, 700 Children's Drive, Columbus, OH, 43205, USA.
Insights
Pediatric urolithiasis hospitalizations decreased, but emergency department visits and healthcare charges increased. This suggests a shift towards outpatient care for pediatric kidney stones, highlighting a need for further research.
Area of Science:
- Pediatric Nephrology
- Urology
- Health Services Research
Background:
- Pediatric urolithiasis trends in hospitalization, emergency department (ED) visits, secondary diagnoses, and associated costs were examined.
- Understanding these trends is crucial for optimizing pediatric kidney stone care.
Purpose of the Study:
- To analyze national trends in pediatric urolithiasis hospitalization, ED utilization, secondary diagnoses, and charges.
- To identify demographic patterns and common comorbidities in affected children.
Main Methods:
- Utilized data from the Kids' Inpatient Database (1997-2012) and HCUP National ED Sample (2006-2011).
- Analyzed changes in discharge rates, ED visits, and inflation-adjusted hospital charges.
Main Results:
- Pediatric nephrolithiasis discharges rose 18%, while ureterolithiasis discharges fell 17%.
- Despite a 2.5% overall discharge decrease, hospital charges increased 20% (inflation-adjusted).
- Pediatric ED visits for urolithiasis increased by 9%; common comorbidities included urinary tract infections (UTI), asthma, and epilepsy.
Conclusions:
- Findings suggest a shift from inpatient to outpatient care for pediatric urolithiasis.
- Rising healthcare charges underscore the economic burden of pediatric kidney stones.
- The need for research into the disease mechanisms and improved therapeutic targets is emphasized due to significant health burdens and long-term risks.
Background:
The goal of this study was to examine national trends in hospitalization, emergency department (ED) utilization, secondary diagnoses, and charges associated with pediatric urolithiasis.
Methods:
Data were evaluated from the Kids' Inpatient Database of the Healthcare Costs and Utilization Project (HCUP) database from 1997 to 2012 and the HCUP National ED Sample from 2006 to 2011.
Results:
Pediatric nephrolithiasis discharges increased by 18%, while ureterolithiasis discharges decreased by 17%. Hospital charges increased by 20% when accounting for inflation, despite an overall decrease in discharges by 2.5%. Female patients and those aged 15-17 years were more commonly affected. Pediatric ED visits increased by 9%. The most common secondary diagnoses during 2003-2009 were urinary tract infections (UTI) (13%), asthma (9%), epilepsy (4%), and paralysis (4%).
Conclusions:
Decreased hospitalizations and increased ED visits indicate a shift to outpatient care. Inpatient health care charges associated with pediatric urolithiasis continue to rise. Comorbidities include UTI, asthma, epilepsy, attention deficit hyperactivity disorder (ADHD), and mood disorders. Because of the significant health care burden and the increased risk to children of developing long-term sequelae there is a strong need for increased research into the mechanism of this systemic inflammatory disease and improved therapeutic targets.
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