Hospital Cost Associated with Pediatrics Urinary Tract Infection: Before and After Health Sector Evolution Program in the West of Iran

Authors

1 Department of Public Health, School of health, Kermanshah University of Medical Sciences, Kermanshah, Iran.

2 Imam Reza Hospital, Kermanshah University of Medical Sciences, Kermanshah, Iran.

3 Children, Cost of hospitalization, Length of stay, Urinary tract infections.

4 Quality Improvement Office, Gachsaran Shahid Rajaee Hospital, Yasuj University of Medical Sciences, Yasuj, Iran.

Abstract

Background: urinary tract infections (UTIs) are one of the most important bacterial infections among children throughout the world. The study aimed to estimate the cost of hospitalization associated with pediatric UTIs in Kermanshah province for the years of 2013 and 2014.
Methods and materials: this was a cross sectional and descriptive study. The study subjects included all those aged 20 years and younger who were admitted to the Imam Reza hospital with the diagnosis primary of the UTI in the studied period. The data on age, sex, length of stay (LOS), and cost of hospitalization were collected by review of medical records. The data analysis was conducted by Stata V.12.
Results: average of age and length of stay was 2.7 years and 6.2 days, respectively. The study showed the average cost per patient and per one day hospitalization was 9206699 and 1484951 IRR, respectively. Patient’s share of total cost of hospitalization in 2013 and 2014 was 1565710 and 982619 IRR, respectively. In addition, there are a significant positive relationship between age, being boy and length of stay and total cost of hospitalization.  
Conclusion: ourfinding implies that the total cost of pediatric UTIs is considerable; at about 2,614,702,516 IRR. In addition, urinary tract infections is more common among females and children with less than 4 year. The study also indicates that Health Sector evolution program causes considerable decrease the patient’s share of total cost of hospitalization (8.7 % vs. 23.4 %). 

Keywords


 

1.             Bachur RG, Harper MB. Predictive model for serious bacterial infections among infants younger than 3 months of age. Pediatrics 2001; 108(2):311–316.

2.         Spencer JD, Schwaderer A, McHugh K, Hains DS. Pediatric urinary tract infections: an analysis of hospitalizations, charges, and costs in the USA. Pediatric Nephrology. 2010;25(12):2469-75.

3.         Elder JS. Urinary tract infections. In: Kliegman RM, Behrman, RE, Jenson, HB, Stanton BE, editors. Nelson Textbook of Pediatrics. Philadelphia: Saunders 2007;2223-2228.

4.         Freedman AL. Urologic diseases in North America Project: trends in resource utilization for urinary tract infections in children. J Urol. 2005;173(3):949–954.

5.         Shaikh N, Morone NE, Bost JE, Farrell MH. Prevalence of urinary tract infection in childhood: a meta-analysis. The Pediatric infectious disease journal. 2008;27(4):302-8.

6.         Foxman B. Epidemiology of urinary tract infections: incidence, morbidity, and economic costs. Disease-a-Month. 2003;2(49):53-70.

7.         Purcell K, Fergie J. Concurrent serious bacterial infections in 2396 infants and children hospitalized with respiratory syncytial virus lower respiratory tract infections. Arch Pediatr Adolesc Med 2002; 156(4):322–324.

8.         Byington CL, Rittichier KK, Bassett KE, Castillo H, Glasgow TS, Daly J, Pavia AT. Serious bacterial infections in febrile infants younger than 90 days of age: the importance of ampicillinresistant pathogens. Pediatrics 2003; 111(5):964–968.

9. Roberts, Kenneth B. Urinary tract infection: clinical practice guideline for the diagnosis and management of the initial UTI in febrile infants and children 2 to 24 months. Pediatrics 2011; 128 (3): 595-610.

10. Shaikh N, Morone NE, Bost JE, Farrell MH. Prevalence of Urinary Tract Infection in Childhood: A Meta-Analysis. April 2008; 27 (4): 302-308.

11.       Winberg J, Andersen HJ, Bergstrom T, Jacobsson B, Larson H, Lincoln K. Epidemiology of symptomatic urinary tract infection in childhood. Acta Paediatr Scand Suppl 1974:1–20.

12.       Shaw KN, Gorelick M, McGowan KL, Yakscoe NM, Schwartz JS. Prevalence of urinary tract infection in febrile young children in the emergency department. Pediatrics 1998; 102:e16.

13.       Schoen EJ, Colby CJ, Ray GT. Newborn circumcision decreases incidence and costs of urinary tract infections during the first year of life. Pediatrics. 2000;105(4):789-93.