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Published on: March 30, 2015
Safety and cost effectiveness of pediatric percutaneous renal biopsy
D S Chesney1, B H Brouhard, R J Cunningham
1Department of Pediatrics, Cleveland Clinic Foundation Children's Hospital, Ohio 44195, USA.
Insights
Outpatient percutaneous renal biopsy for children is as safe as inpatient procedures but significantly more cost-effective. This approach offers substantial savings, making it a preferred option for pediatric renal biopsies.
Area of Science:
- Nephrology
- Pediatric Surgery
- Health Economics
Background:
- Increasing healthcare costs are driving a shift towards outpatient procedures.
- Pediatric patients are increasingly managed as outpatients rather than inpatients.
Purpose of the Study:
- To compare the safety and cost-effectiveness of outpatient versus inpatient percutaneous renal biopsy in children.
- To evaluate complication rates and financial implications of different procedural settings.
Main Methods:
- Retrospective chart review of pediatric patients undergoing percutaneous renal biopsy between January 1989 and January 1995.
- Analysis included patient age, biopsy type (native vs. allograft), preparation costs, and complication incidence.
- Statistical comparison of outcomes between outpatient and inpatient groups.
Main Results:
- Out of 75 biopsies, 35 were outpatient and 40 were inpatient.
- Complication rates were similar: 11.4% (2 patients) for outpatient vs. 17.5% (6 patients) for inpatient (P = 0.75).
- Median cost for outpatient biopsy was $1,968 versus $3,178 for inpatient, a saving of over $1,000 per procedure.
Conclusions:
- Outpatient percutaneous renal biopsy in children is a safe alternative to inpatient procedures.
- The outpatient setting offers significant economic benefits, reducing healthcare expenditures.
- This approach supports the trend towards more cost-efficient pediatric healthcare delivery.
Abstract:
Because of the rising cost of health care, more patients are undergoing procedures as outpatients rather than inpatients. The purpose of this study was to compare safety and cost of outpatient versus inpatient, overnight stay, for children undergoing percutaneous renal biopsy. Charts of all such patients between January 1989 through January 1995 were reviewed for the following: age of patient, native versus allograft biopsy and preparation costs (in 1995 U.S. dollars), and complications. Of the 75 biopsies reviewed, 58 were native and 17 allograft with 35 (47%) of the biopsies being outpatient and 40 (53%) inpatient. There were four complications (11.4%) in 2 patients for the outpatient group and seven complications (17.5%) in 6 patients in the inpatient group (X2 = 0.1003, P = 0.75). The median cost for an outpatient biopsy was U.S. $1,968 while an inpatient biopsy was U.S. $3,178. We conclude that outpatient percutaneous renal biopsy in children is as safe as inpatient and more economic, with a saving of greater than U.S. $1,000 per biopsy.
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