Does hospital type affect pyloromyotomy outcomes? Analysis of the Kids' Inpatient Database

Research output: Contribution to journalArticle

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Abstract

Background: Pyloromyotomy is a common operative procedure performed on infants. The purpose of this study was to determine if hospital type affects lengths of stay (LOS), charges, and morbidity. Methods: Patients undergoing pyloromyotomy were identified in the Kids' Inpatients Database from 2000, 2003, and 2006. Freestanding children's hospitals (CH) were compared with children's units within general hospitals (CUGH) and general/nonchildren's hospitals (GH). Results: Of the 10,969 patients, 25% received care at 30 CH, 35% received care at 94 CUGH, and 40% received care at 662 GH. Adjusted LOS were 2.41 days for CH, 2.75 days for CUGH, and 2.82 days for GH (P < .01). Adjusted mean charges were $11,160 for CH, $12,284 for CUGH, and $10,197 for GH (P = .01). CH had the lowest unadjusted complication rate at 1.2% compared with 1.6% at CUGH and 2.2% at GH (P < .01). GH were more likely to have patients with prolonged LOS (≥4 days) compared with CH after adjusting for patient and hospital factors (odds ratio [OR], 1.7; 95% confidence interval [CI], 1.2-2.5). After accounting for LOS, CUGH were more likely to have higher charges (≥$11,057) compared with CH (OR, 3.4; 95% CI, 1.03-11.18). The adjusted mean charges rose from $7,733 in 2000 to $11,335 in 2003 and to $14,572 in 2006 (P < .01). Conclusion: CH had the shortest LOS and lowest complication rates. Despite a higher complication rate and longer LOS, GH had the lowest charges. There is an opportunity to identify best practices, to improve quality, and to lower costs for pyloromyotomy in the United States, regardless of hospital type.

Original languageEnglish (US)
Pages (from-to)411-419
Number of pages9
JournalSurgery
Volume148
Issue number2
DOIs
StatePublished - May 31 2010

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General Hospitals
Inpatients
Databases
Length of Stay
Odds Ratio
Confidence Intervals
State Hospitals
Operative Surgical Procedures
Practice Guidelines
Morbidity
Costs and Cost Analysis

ASJC Scopus subject areas

  • Surgery

Cite this

@article{0d6ea1dc50b34e959d2cbcb56a115a5e,
title = "Does hospital type affect pyloromyotomy outcomes? Analysis of the Kids' Inpatient Database",
abstract = "Background: Pyloromyotomy is a common operative procedure performed on infants. The purpose of this study was to determine if hospital type affects lengths of stay (LOS), charges, and morbidity. Methods: Patients undergoing pyloromyotomy were identified in the Kids' Inpatients Database from 2000, 2003, and 2006. Freestanding children's hospitals (CH) were compared with children's units within general hospitals (CUGH) and general/nonchildren's hospitals (GH). Results: Of the 10,969 patients, 25{\%} received care at 30 CH, 35{\%} received care at 94 CUGH, and 40{\%} received care at 662 GH. Adjusted LOS were 2.41 days for CH, 2.75 days for CUGH, and 2.82 days for GH (P < .01). Adjusted mean charges were $11,160 for CH, $12,284 for CUGH, and $10,197 for GH (P = .01). CH had the lowest unadjusted complication rate at 1.2{\%} compared with 1.6{\%} at CUGH and 2.2{\%} at GH (P < .01). GH were more likely to have patients with prolonged LOS (≥4 days) compared with CH after adjusting for patient and hospital factors (odds ratio [OR], 1.7; 95{\%} confidence interval [CI], 1.2-2.5). After accounting for LOS, CUGH were more likely to have higher charges (≥$11,057) compared with CH (OR, 3.4; 95{\%} CI, 1.03-11.18). The adjusted mean charges rose from $7,733 in 2000 to $11,335 in 2003 and to $14,572 in 2006 (P < .01). Conclusion: CH had the shortest LOS and lowest complication rates. Despite a higher complication rate and longer LOS, GH had the lowest charges. There is an opportunity to identify best practices, to improve quality, and to lower costs for pyloromyotomy in the United States, regardless of hospital type.",
author = "Raval, {Mehul V} and Cohen, {Mark E.} and Barsness, {Katherine A} and Bentrem, {David Jason} and Phillips, {J. Duncan} and Marleta Reynolds",
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language = "English (US)",
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Does hospital type affect pyloromyotomy outcomes? Analysis of the Kids' Inpatient Database. / Raval, Mehul V; Cohen, Mark E.; Barsness, Katherine A; Bentrem, David Jason; Phillips, J. Duncan; Reynolds, Marleta.

In: Surgery, Vol. 148, No. 2, 31.05.2010, p. 411-419.

Research output: Contribution to journalArticle

TY - JOUR

T1 - Does hospital type affect pyloromyotomy outcomes? Analysis of the Kids' Inpatient Database

AU - Raval, Mehul V

AU - Cohen, Mark E.

AU - Barsness, Katherine A

AU - Bentrem, David Jason

AU - Phillips, J. Duncan

AU - Reynolds, Marleta

PY - 2010/5/31

Y1 - 2010/5/31

N2 - Background: Pyloromyotomy is a common operative procedure performed on infants. The purpose of this study was to determine if hospital type affects lengths of stay (LOS), charges, and morbidity. Methods: Patients undergoing pyloromyotomy were identified in the Kids' Inpatients Database from 2000, 2003, and 2006. Freestanding children's hospitals (CH) were compared with children's units within general hospitals (CUGH) and general/nonchildren's hospitals (GH). Results: Of the 10,969 patients, 25% received care at 30 CH, 35% received care at 94 CUGH, and 40% received care at 662 GH. Adjusted LOS were 2.41 days for CH, 2.75 days for CUGH, and 2.82 days for GH (P < .01). Adjusted mean charges were $11,160 for CH, $12,284 for CUGH, and $10,197 for GH (P = .01). CH had the lowest unadjusted complication rate at 1.2% compared with 1.6% at CUGH and 2.2% at GH (P < .01). GH were more likely to have patients with prolonged LOS (≥4 days) compared with CH after adjusting for patient and hospital factors (odds ratio [OR], 1.7; 95% confidence interval [CI], 1.2-2.5). After accounting for LOS, CUGH were more likely to have higher charges (≥$11,057) compared with CH (OR, 3.4; 95% CI, 1.03-11.18). The adjusted mean charges rose from $7,733 in 2000 to $11,335 in 2003 and to $14,572 in 2006 (P < .01). Conclusion: CH had the shortest LOS and lowest complication rates. Despite a higher complication rate and longer LOS, GH had the lowest charges. There is an opportunity to identify best practices, to improve quality, and to lower costs for pyloromyotomy in the United States, regardless of hospital type.

AB - Background: Pyloromyotomy is a common operative procedure performed on infants. The purpose of this study was to determine if hospital type affects lengths of stay (LOS), charges, and morbidity. Methods: Patients undergoing pyloromyotomy were identified in the Kids' Inpatients Database from 2000, 2003, and 2006. Freestanding children's hospitals (CH) were compared with children's units within general hospitals (CUGH) and general/nonchildren's hospitals (GH). Results: Of the 10,969 patients, 25% received care at 30 CH, 35% received care at 94 CUGH, and 40% received care at 662 GH. Adjusted LOS were 2.41 days for CH, 2.75 days for CUGH, and 2.82 days for GH (P < .01). Adjusted mean charges were $11,160 for CH, $12,284 for CUGH, and $10,197 for GH (P = .01). CH had the lowest unadjusted complication rate at 1.2% compared with 1.6% at CUGH and 2.2% at GH (P < .01). GH were more likely to have patients with prolonged LOS (≥4 days) compared with CH after adjusting for patient and hospital factors (odds ratio [OR], 1.7; 95% confidence interval [CI], 1.2-2.5). After accounting for LOS, CUGH were more likely to have higher charges (≥$11,057) compared with CH (OR, 3.4; 95% CI, 1.03-11.18). The adjusted mean charges rose from $7,733 in 2000 to $11,335 in 2003 and to $14,572 in 2006 (P < .01). Conclusion: CH had the shortest LOS and lowest complication rates. Despite a higher complication rate and longer LOS, GH had the lowest charges. There is an opportunity to identify best practices, to improve quality, and to lower costs for pyloromyotomy in the United States, regardless of hospital type.

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