Practice patterns and resource utilization for infants with bladder exstrophy: a national perspective.
Practice patterns and resource utilization for infants with bladder exstrophy: a national perspective.
复制标题
膀胱外翻婴儿的实践模式和资源利用：全国视角。
DOI：
10.1016/j.juro.2013.11.054
复制
发表时间：
2014
期刊：
影响因子：
--
通讯作者：
Nelson,CalebP
中科院分区：
文献类型：
--
作者：
Schaeffer,AnthonyJ;Johnson,EmilieK;Logvinenko,Tanya;Graham,DionneA;Borer,JosephG;Nelson,CalebP
目的：膀胱外翻的治疗存在着很大的差异性，而且人们对膀胱外翻的相关费用知之甚少。我们定义护理模式和第一年的费用患者膀胱外翻在美国选择独立儿科医院。材料和方法我们使用儿科健康信息系统数据库，识别1999年1月至2010年12月出生的膀胱外翻患者，这些患者在出生后的120天内进行了初步缝合。评估所有接触病例的人口统计、手术、术后和费用数据。使用多元线性回归来检验患者、外科医生和医院特征与成本之间的关系。结果在381例患者中，279例（73%）在出生后的前3天内进行了原发性关闭。共有119例患者（31%）接受了骨盆截骨术，其中279例患者中有51例（18%）在出生后3天内进行了截骨术，67例患者中有38例（56%）在出生后4 - 30天进行了截骨术，35例患者中有30例（86%）在出生后31 - 120天进行了截骨术（p= 0.0017）。经通胀调整后的中位数，每名患者第一年的费用为66,577美元（45,335美元）102398) .Presenceofnonrenalcomorbidityandcompletionofprimaryclosureafter30daysoflifeincreasedfirstyearcostsby24%and53%、respectively.Increasedpost-closurelengthofstaywasassociatedwithgreatercosts.ConclusionsAtselectfreestandingUnitedStatespediatrichospitalsthemajorityofbladderexstrophyclosuresareperformedwithinthefirst3daysoflife.Most butnotall patientsundergoingclosureaftertheneonatalperiodundergoosteotomy.Thepresenceofnonrenalcomorbidityandincreasedpostoperativelengthofstayareassociatedwithgreatercosts。
PurposeSubstantial variability exists in bladder exstrophy care, and little is known about costs associated with the condition. We define the care patterns and first year cost for patients with bladder exstrophy at select freestanding pediatric hospitals in the United States.Materials and MethodsWe used the Pediatric Health Information System database to identify patients with bladder exstrophy born between January 1999 and December 2010 who underwent primary closure in the first 120 days of life. Demographic, surgical, postoperative and cost data for all encounters were assessed. Multivariate linear regression was used to examine the association between patient, surgeon and hospital characteristics and costs.ResultsOf the 381 patients who underwent primary closure within the first 120 days of life 279 (73%) did so within the first 3 days of life. A total of 119 patients (31%) underwent pelvic osteotomy, including 51 of 279 (18%) who underwent closure within the first 3 days of life, 38 of 67 (56%) who underwent closure between 4 and 30 days of life, and 30 of 35 (86%) who underwent closure between 31 and 120 days of life (p= 0.0017). Median inflation adjusted, first year cost in United States dollars per patient was 66,577(IQR 45,335 to 102,398).Presenceofnonrenalcomorbidityandcompletionofprimaryclosureafter30daysoflifeincreasedfirstyearcostsby24%and53%,respectively.Increasedpost-closurelengthofstaywasassociatedwithgreatercosts.ConclusionsAtselectfreestandingUnitedStatespediatrichospitalsthemajorityofbladderexstrophyclosuresareperformedwithinthefirst3daysoflife.Most,butnotall,patientsundergoingclosureaftertheneonatalperiodundergoosteotomy.Thepresenceofnonrenalcomorbidityandincreasedpostoperativelengthofstayareassociatedwithgreatercosts.
登录
查看更多内容
影响因子：
6.6
作者：
Nelson, Caleb P.;North, Amanda C.;Gearhart, John P.
通讯作者：
Gearhart, John P.
影响因子：
6.6
作者：
Nelson, CP;Dunn, RL;Gearhart, JP
通讯作者：
Gearhart, JP
影响因子：
6.6
作者：
Baradaran, Nima;Cervellione, Raimondo M.;Gearhart, John P.
通讯作者：
Gearhart, John P.
外翻完全初级修复的长期随访：西雅图经验。
影响因子：
6.6
作者：
M. Shnorhavorian;R. Grady;A. Andersen;B. Joyner;M. Mitchell
通讯作者：
M. Mitchell
对晚期就诊和初次闭合失败的儿童进行膀胱外翻的完全初级修复：单中心经验。
DOI：
10.1097/01.ju.0000179191.45671.3b
发表时间：
2005
期刊：
The Journal of urology
影响因子：
--
作者：
A. Hafez;M. El;A. Shorrab;Hany El
通讯作者：
Hany El