133 COST VARIATIONS OF PEDIATRIC PYELOPLASTY AND VESICOURETERAL REIMPLANTS FROM THE UNIVERSITY HEALTH CONSORTIUM DATABASE

Abstract

You have accessJournal of UrologyGeneral & Epidemiological Trends & Socioeconomics: Practice Patterns, Cost Effectiveness I1 Apr 2012133 COST VARIATIONS OF PEDIATRIC PYELOPLASTY AND VESICOURETERAL REIMPLANTS FROM THE UNIVERSITY HEALTH CONSORTIUM DATABASE Ruthie Su and Paul Merguerian Ruthie SuRuthie Su Seattle, WA More articles by this author and Paul MerguerianPaul Merguerian Seattle, WA More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2012.02.182AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES Variation in health care costs is known to exist in the United States but there is limited information on the extent to which these differences occur in the pediatric urology community. We examine cost variations in the United States for pyeloplasties and vesicoureteral reimplants in the pediatric population and ask whether differences in cost were associated with hospital case volume, co-morbidities, complications, or geographic regions. METHODS Data was analyzed from the University Health Consortium (UHC) database. Hospitals reporting costs for pyeloplasty or reimplant procedures on patients less than 17 years old between January 2010 to January 2011were included. Case volume, direct cost, direct cost index (observed costs/ expected costs), case mix index (CMI), length of stay (LOS), and complications were evaluated amongst all university hospitals. These characteristics were examined between Western, New England, Mid-Atlantic, Mid-west, and Southeastern regions. Freestanding children's hospitals were compared to non children's hospitals. RESULTS Data was available for a total of 58 hospitals, 14 of which were free standing chidren's hospitals. Variation in direct costs ranged from $2,363 to $14,136 for pyeloplasty and $2,305 to $11,206 for reimplantation. The overall average direct cost index for the pyeloplasty procedure was 1.13 (range 0.44-2.38) and 1.00 (range 0.31-1.98) for reimplants. For reimplants we did not find statistically significant cost variation. Hospitals that performed greater than 20 pyeloplasties in a year had a higher average direct cost index compared to hospitals that performed less than 20 pyeloplasties in a year (1.41 vs 1.08, p<0.05). There were no differences in CMI, LOS, complications, or between children's and non children's hospitals. The Western region had a significantly higher direct cost index (1.44) compared to other regions; the New England region had the second highest (1.21). CONCLUSIONS There is significant cost variation for a pyeloplasty, but not a reimplant procedure. The higher cost hospitals included those that performed more than 20 pyeloplasties per year and were concentrated in the Western and New England regions. Further studies are needed to elucidate why these cost variations exist and whether increased costs can be justified with better health outcomes. © 2012 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 187Issue 4SApril 2012Page: e55 Advertisement Copyright & Permissions© 2012 by American Urological Association Education and Research, Inc.MetricsAuthor Information Ruthie Su Seattle, WA More articles by this author Paul Merguerian Seattle, WA More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...