Inpatient healthcare utilization by children and adolescents with systemic lupus erythematosus and kidney involvement
Arthritis Care & Research , 08/20/2012
Tanzer M et al. – In the USA, over 7,000 hospitalizations occurred in 2006 among children with Systemic Lupus Erythematosus (SLE) with nearly 57% demonstrating kidney involvement Kidney involvement is a major determinant of hospitalization charges for these children. This study represents one of the first large scale assessments of in–hospital healthcare utilization by children with SLE.Methods
- The Healthcare Cost and Utilization Project Kid's Inpatient Database, years 2000, 2003 and 2006 was used for this analysis.
- SLE hospitalizations from the 2006 cohort were identified and classified as those with versus without kidney involvement by ICD-9 code.
- Analyses were performed to examine determinants of hospitalization charges and changes in charges over time.
- In the USA, 7390 SLE related pediatric hospitalizations generated $267 million in total charges in 2006.
- Of these, 4194 discharges had kidney involvement.
- The average hospitalization charge was greater for SLE patients with kidney involvement compared to those without kidney involvement ($43.1 thousand versus $28.5 thousand, p<0.0001).
- In multivariate analysis, kidney involvement remained a significant predictor of hospitalization charges, independent of demographic and hospital characteristics (p<0.0001).
- SLE associated acute kidney failure, transplant, and end stage kidney disease resulted in greater hospitalization charges than SLE without kidney involvement by $74.9 thousand (p<0.0001), $32.7 thousand (p=0.0002) and $27.4 thousand (p<0.0001), respectively.