Costs of Venous Thromboembolism, Catheter-Associated Urinary Tract Infection, and Pressure Ulcer.

TitleCosts of Venous Thromboembolism, Catheter-Associated Urinary Tract Infection, and Pressure Ulcer.
Publication TypeJournal Article
Year of Publication2015
AuthorsGoudie A, Dynan L, Brady PW, Fieldston ES, Brilli RJ, Walsh KE
JournalPediatrics
Volume136
Issue3
Pagination432-9
Date Published2015 Sep
ISSN1098-4275
Abstract

OBJECTIVE: To estimate differences in the length of stay (LOS) and costs for comparable pediatric patients with and without venous thromboembolism (VTE), catheter-associated urinary tract infection (CAUTI), and pressure ulcer (PU).

METHODS: We identified at-risk children 1 to 17 years old with inpatient discharges in the Nationwide Inpatient Sample. We used a high dimensional propensity score matching method to adjust for case-mix at the patient level then estimated differences in the LOS and costs for comparable pediatric patients with and without VTE, CAUTI, and PU.

RESULTS: Incidence rates were 32 (VTE), 130 (CAUTI), and 3 (PU) per 10 000 at-risk patient discharges. Patients with VTE had an increased 8.1 inpatient days (95% confidence interval [CI]: 3.9 to 12.3) and excess average costs of $27 686 (95% CI: $11 137 to $44 235) compared with matched controls. Patients with CAUTI had an increased 2.4 inpatient days (95% CI: 1.2 to 3.6) and excess average costs of $7200 (95% CI: $2224 to $12 176). No statistical differences were found between patients with and without PU.

CONCLUSIONS: The significantly extended LOS highlights the substantial morbidity associated with these potentially preventable events. Hospitals seeking to develop programs targeting VTE and CAUTI should consider the improved turnover of beds made available by each event prevented.

DOI10.1542/peds.2015-1386
Alternate JournalPediatrics
PubMed ID26260712