Hospitalization costs of cystic fibrosis in the United States: a retrospective analysis

Vadagam, Pratyusha; Kamal, Khalid M.

doi:10.1080/21548331.2018.1505407

Cited by 14 publications

(8 citation statements)

References 8 publications

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“…These costs are comparable to those reported for hospitalized CF exacerbations in the US 29. In 2012, mean hospital costs for each paediatric CF admission was USD 26 249.23 for a mean LOS of 9.79 days 29. The Australian IHPA reported that in 2016 the allocated DRG for CF (E60) allowed for a cost of AUD 25 116 with a mean LOS of 11.6 days in patients (adult or children) with ‘major complexity’ (based on the complexity classification according to the AR‐DRG30) and AUD 15 348 with an LOS of 8.65 days for those rated with minor complexity during the corresponding financial year 31.…”

Section: Discussionsupporting

confidence: 72%

“…These data highlight the large economic burden from hospitalization for exacerbations of bronchiectasis. These costs are comparable to those reported for hospitalized CF exacerbations in the US 29. In 2012, mean hospital costs for each paediatric CF admission was USD 26 249.23 for a mean LOS of 9.79 days 29.…”

Section: Discussionsupporting

confidence: 66%

“…29 In 2012, mean hospital costs for each paediatric CF admission was USD 26 249.23 for a mean LOS of 9.79 days. 29 The Australian IHPA reported that in 2016 the allocated DRG for CF (E60) allowed for a cost of AUD 25 116 with a mean LOS of 11.6 days in patients (adult or children) with 'major complexity' (based on the complexity classification according to the AR-DRG 30 ) and AUD 15 348 with an LOS of 8.65 days for those rated with minor complexity during the corresponding financial year. 31 The addition of a bronchiectasis DRG to the AR-DRG classification system will allow a more accurate determination of the disease and economic burden within Australian hospitals.…”

Section: Discussionmentioning

confidence: 99%

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Cost of hospitalization for bronchiectasis exacerbation in children

et al. 2020

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Background and objective: Despite paediatric bronchiectasis being recognized increasingly worldwide, prior reports of hospitalization costs for bronchiectasis in children are lacking. This study aimed to (i) identify health service costs of hospitalizations and (ii) factors associated with these costs in children admitted to an Australian paediatric hospital following an acute exacerbation of their bronchiectasis. Methods: Demographic and hospital resource use data were prospectively recorded for 100 hospitalizations in 80 children aged <18 years admitted consecutively to the QCH, Brisbane, Australia. Costs (2016 AUD) were obtained from the hospital's Finance Department. Linear regressions, with bootstrap resampling to quantify uncertainty, were used to estimate factors affecting cost of hospitalization. Results: The 100 hospitalizations (48 males) had a median (IQR) age of 6.04 (4.04-9.85) years. Their mean (SD) LOS was 12.30 (4.60) days. The mean (SD) direct health service cost was AUD 30 182 (13 998) per hospitalization. The greatest contributor to costs was health professional wages, accounting for 70% of the cost per episode. LOS, younger age at admission and number of bronchiectatic lobes affected were associated with higher costs, whilst HITH service was associated with lower cost. The cost to families on average was AUD 2669.50 (SD: 991.50) per hospitalization when accounting for lost wages and opportunity cost. Conclusion: The per episode healthcare cost burden of hospitalizations for paediatric bronchiectasis exacerbations is substantial. Interventions that prevent hospitalized exacerbations and reduce severity of childhood bronchiectasis with even moderate effectiveness are likely to result in substantial hospital costs savings.

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Section: Discussionsupporting

confidence: 72%

Section: Discussionsupporting

confidence: 66%

Section: Discussionmentioning

confidence: 99%

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Cost of hospitalization for bronchiectasis exacerbation in children

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“…We read the article posted by Vadagam et al [1]. with great interest and would like to provide an update on some aspects of the article.…”

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confidence: 99%

An update on admissions of cystic fibrosis children in the United States based on national databases

2019

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“…340 In 2012, mean hospital costs of each CF admission was USD26, 249.23 (SD 40,592.81) for a mean LOS of 9.79 (SD 10.51) days. 340 In 2016, the allocated diagnostic-related group (DRG) for CF (E60) in Australia allowed for an expenditure of AUD25,116 dollars with mean LOS of 11.6-days in patients with 'major complexity' (based on the complexity classification according to the AR-DRG 341 ) and $15,348 with a LOS of 8.65-days for those rated with minor complexity during the corresponding financial year. 342 Currently, as a DRG was only assigned to bronchiectasis in Australia in 2018, there is no dollar value allocated to this chronic disorder.…”

Section: Discussionmentioning

confidence: 99%

Advancing the knowledge, understanding and management of respiratory exacerbations of bronchiectasis in children

Goyal¹

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IntroductionBronchiectasis unrelated to cystic fibrosis (CF) remains an under-researched area and is often labelled a "neglected disease". Yet, worldwide it is more common than CF and causes substantial morbidity and mortality in both children and adults.To reduce morbidity and premature mortality from bronchiectasis in adults, interventions should begin in childhood. Diagnosing bronchiectasis early and providing effective treatment, including treating exacerbations, can prevent significant morbidity. Although the importance of recognising and treating exacerbations effectively is well-accepted, there have been no prior randomised trials for managing exacerbations of bronchiectasis in children. The studies in my PhD address several important clinical and research gaps relating to children with bronchiectasis, including its early identification and antibiotic treatment of exacerbations. AimsThe overarching aim of my thesis is to improve knowledge of bronchiectasis, the pre-bronchiectasis state and management of bronchiectasis exacerbations in children.The specific main objectives were to: 1. Identify whether children with a poor response to at least 4-weeks of oral antibiotics predict an increased risk of finding bronchiectasis on a multi-detector computed-tomography (MDCT) scan of the chest. 2. Describe the clinical characteristics, investigations and treatment outcomes for children with chronic suppurative lung disease (CSLD) without radiographic evidence of bronchiectasis. 3. Determine in children with bronchiectasis the effect of oral azithromycin and oral amoxicillinclavulanate (each compared to placebo) on symptom resolution after 14-days treatment of nonsevere (non-hospitalised) acute respiratory exacerbations. 4. Asses in children with bronchiectasis whether oral azithromycin was non-inferior (within a 20% margin) to oral amoxicillin-clavulanate at achieving symptom resolution after 21-days treatment of non-severe (non-hospitalised) acute respiratory exacerbations. iv Vikas Goyal -August 2019 5. Estimate the cost of hospitalised bronchiectasis exacerbations. 6. Undertake a systematic review using Cochrane methodology to assess the effects of inhaled longacting beta-2-agonists (LABA) combined with inhaled corticosteroids (ICS) in children and adults with bronchiectasis during (a) acute exacerbations and (b) stable state.An overview of the major findings for each objective is detailed below:Objective-1 was addressed by studying 144 children undergoing chest CT scans for a chronic wet cough.Among the 105 children with persistent cough despite at least 4-weeks of antibiotics, 88 (83.8%) had bronchiectasis. In contrast, of the 24 children whose cough resolved after 4-weeks of antibiotics, only six (25.0%) received this diagnosis (adjusted OR 20.9; 95%CI 5.36 to 81.8). 1 The study addressing objective-2 is the first to describe children with CSLD. These 22 children lacked features of bronchiectasis on CT scans but had a wet cough unresponsive to oral antibiotics, which resolved with intravenous antibiotics an...

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Hospitalization costs of cystic fibrosis in the United States: a retrospective analysis

Cited by 14 publications

References 8 publications

Cost of hospitalization for bronchiectasis exacerbation in children

Cost of hospitalization for bronchiectasis exacerbation in children

An update on admissions of cystic fibrosis children in the United States based on national databases

Advancing the knowledge, understanding and management of respiratory exacerbations of bronchiectasis in children

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