scholarly journals Trends of Hospitalization in Acute Pancreatitis in Patients in the United States from 2001-2014

2019 ◽  
Author(s):  
Kevin Casey ◽  
Roberto Argo ◽  
Albert Bianco
Keyword(s):  
United States ◽  
Acute Pancreatitis ◽  
Length Of Hospital Stay ◽  
The United States ◽  
Primary Objective ◽  
Hospital Charges ◽  
Cost Burden ◽  
Patient Demographics ◽  
The Mean ◽  
The Cost

Background & Purpose: The prevalence of acute pancreatitis(AP) has increased over time and is one of the most important gastrointestinal causes of frequent admissions to hospital in the United States. The cost burden of AP has been steadily increasing. The primary objective of our study was to analyze patient demographics, cost burden, mortality and length of stay associated with AP hospital admissions.Methods: Nationwide inpatient sample (NIS) database was used to identify AP admissions in all patients from ≥18 years of age from 2001 to 2014 using ICD-9-CM code 577.0 as the principal discharge diagnosisResults: The number of hospitalizations increased from 215,238 in 2001 to 279,145 in 2014. In-hospital mortality decreased from 1.74% in 2001 to 0.66% in 2014. Mean length of hospital stay has decreased from 6.1 days to 4.6 days during the same period, but the mean hospital charges increased from $19,303 in 2001 to $35,728 in 2014. The proportion of males to females with acute pancreatitis is slowly trending up from 2001 to 2014. Conclusion: The number of hospitalizations due to acute pancreatitis has been steadily increasing, and further research needs to be done on finding out the reasons for increased causes of hospitalization and ways to decrease the cost burden on patients and hospitals.

scholarly journals Trends of Hospitalization in Acute Pancreatitis in Patients in the United States from 2001-2014

2019 ◽  
Author(s):  
Kevin Casey ◽  
Roberto Argo ◽  
Albert Bianco
Keyword(s):  
United States ◽  
Acute Pancreatitis ◽  
Hospital Admissions ◽  
Length Of Hospital Stay ◽  
The United States ◽  
Primary Objective ◽  
Hospital Charges ◽  
Inhospital Mortality ◽  
Cost Burden ◽  
The Cost

ABSTRACTBackground & PurposeThe prevalence of acute pancreatitis(AP) has increased over time and is one of the most important gastrointestinal causes of frequent admissions to hospital in the United States. The cost burden of AP has been steadily increasing. The primary objective of our study was to analyze patient demographics, cost burden, mortality and length of stay associated with AP hospital admissions.MethodsNationwide inpatient sample (NIS) database was used to identify AP admissions in all patients from ≥18 years of age from 2001 to 2014 using ICD-9-CM code 577.0 as the principal discharge diagnosisResultsThe number of hospitalizations increased from 215,238 in 2001 to 279,145 in 2014. Inhospital mortality decreased from 1.74% in 2001 to 0.66% in 2014. Mean length of hospital stay has decreased from 6.1 days to 4.6 days during the same period, but the mean hospital charges increased from $19,303 in 2001 to $35,728 in 2014. The proportion of males to females with acute pancreatitis is slowly trending up from 2001 to 2014.ConclusionThe number of hospitalizations due to acute pancreatitis has been steadily increasing, and further research needs to be done on finding out the reasons for increased causes of hospitalization and ways to decrease the cost burden on patients and hospitals.

scholarly journals Total elbow arthroplasty in the United States: evaluation of cost, patient demographics, and complication rates

2016 ◽  
Vol 8 (1) ◽  
Author(s):  
Hanbing Zhou ◽  
Nathan D. Orvets ◽  
Gabriel Merlin ◽  
Joshua Shaw ◽  
Joshua S. Dines ◽  
...  
Keyword(s):  
United States ◽  
Direct Cost ◽  
Complication Rate ◽  
Readmission Rate ◽  
The United States ◽  
Total Elbow Arthroplasty ◽  
Complication Rates ◽  
Patient Demographics ◽  
Elbow Arthroplasty ◽  
The Mean

Total elbow arthroplasty (TEA) is utilized in the treatment of rheumatoid and post-traumatic elbow arthritis. TEA is a relatively low volume surgery in comparison to other types of arthroplasty and therefore little is known about current surgical utilization, patient demographics and complication rates in the United States. The purpose of our study is to evaluate the current practice trends and associated inpatient complications of TEA at academic centers in the United States. We queried the University Health Systems Consortium administrative database from 2007 to 2011 for patients who underwent an elective TEA. A descriptive analysis of demographics was performed which included patient age, sex, race, and insurance status. We also evaluated the following patient clinical benchmarks: hospital length of stay (LOS), hospital direct cost, inhospital mortality, complications, and 30-day readmission rates. Our cohort consisted of 3146 adult patients (36.5% male and 63.5% female) with an average age of 58 years who underwent a total elbow arthroplasty (159 academic medical centers) in the United States. The racial demographics included 2334 (74%) Caucasian, 285 (9%) black, 236 (7.5%) Hispanic, 16 (0.5%) Asian, and 283 (9%) other patients. The mean LOS was 4.2±5 days and the mean total direct cost for the hospital was 16,300±4000 US Dollars per case. The overall inpatient complication rate was 3.1% and included mortality <1%, DVT (0.8%), re-operation (0.5%), and infection (0.4%). The 30-day readmission rate was 4.4%. TEA is a relatively uncommon surgery in comparison to other forms of arthroplasty but is associated with low in-patient and 30-day perioperative complication rate. Additionally, the 30-day readmission rate and overall hospital costs are comparable to the traditional total hip and knee arthroplasty surgeries.

scholarly journals Comprehensive survey of United States internet users’ sentiments towards cryopreservation

PLoS ONE ◽  
2021 ◽  
Vol 16 (1) ◽  
pp. e0244980
Author(s):  
Christopher Robert Gillett ◽  
Taylor Brame ◽  
Emil F. Kendiorra
Keyword(s):  
United States ◽  
Low Temperatures ◽  
The United States ◽  
Fear Of Death ◽  
Cryoprotective Agents ◽  
Internet Users ◽  
Comprehensive Survey ◽  
Attitudes Towards Death ◽  
The Mean ◽  
The Cost

Medical cryopreservation is the speculative practice of using low temperatures and medical-grade cryoprotective agents to halt the decay of a recently-deceased person’s brain and body for the prospect of future resuscitation and restoration of function. We conducted a survey of 1,487 internet users in the United States to measure familiarity with, interest in, beliefs about, and attitudes towards cryopreservation. The majority of respondents (75%) had previously heard of the topic. Respondents tended to underestimate the cost of cryopreservation and number of previous cases but overestimate the number of providers. While many respondents expressed interest in signing up (20%) or had actively researched the topic (21%), a much smaller fraction have decided to be cryopreserved (6%). This level of interest is much greater than the number of previous preservation cases would indicate. We found that respondents’ attitudes towards death significantly correlated with their general sentiments towards the topic, with those expressing a desire for longer life or to see the future being more interested and positively inclined. Fear of death was not associated with interest in cryopreservation. Negative sentiments towards cryopreservation were less common than respondents perceived. For example, 14% of respondents believed that “most people” think cryopreservation should be illegal, but only 4% of respondents actually did. Many respondents (42%) were pessimistic regarding the likelihood of cryopreservation being successful, but the mean estimate of time until revival of cryopreserved bodies would be possible was 82 years.

scholarly journals Equine Botulinum Antitoxin for the Treatment of Infant Botulism

2011 ◽  
Vol 18 (11) ◽  
pp. 1845-1849 ◽  
Author(s):  
Elida E. Vanella de Cuetos ◽  
Rafael A. Fernandez ◽  
María I. Bianco ◽  
Omar J. Sartori ◽  
María L. Piovano ◽  
...  
Keyword(s):  
United States ◽  
Mechanical Ventilation ◽  
Intensive Care ◽  
Medical Records ◽  
Tube Feeding ◽  
Specific Treatment ◽  
Length Of Hospital Stay ◽  
The United States ◽  
Infant Botulism ◽  
The Mean

ABSTRACTInfant botulism is the most common form of human botulism in Argentina and the United States. BabyBIG (botulism immune globulin intravenous [human]) is the antitoxin of choice for specific treatment of infant botulism in the United States. However, its high cost limits its use in many countries. We report here the effectiveness and safety of equine botulinum antitoxin (EqBA) as an alternative treatment. We conducted an analytical, observational, retrospective, and longitudinal study on cases of infant botulism registered in Mendoza, Argentina, from 1993 to 2007. We analyzed 92 medical records of laboratory-confirmed cases and evaluated the safety and efficacy of treatment with EqBA. Forty-nine laboratory-confirmed cases of infant botulism demanding admission in intensive care units and mechanical ventilation included 31 treated with EqBA within the 5 days after the onset of signs and 18 untreated with EqBA. EqBA-treated patients had a reduction in the mean length of hospital stay of 23.9 days (P= 0.0007). For infants treated with EqBA, the intensive care unit stay was shortened by 11.2 days (P= 0.0036), mechanical ventilation was reduced by 11.1 days (P= 0.0155), and tube feeding was reduced by 24.4 days (P= 0.0001). The incidence of sepsis in EqBA-treated patients was 47.3% lower (P= 0.0017) than in the untreated ones. Neither sequelae nor adverse effects attributable to EqBA were noticed, except for one infant who developed a transient erythematous rash. These results suggest that prompt treatment of infant botulism with EqBA is safe and effective and that EqBA could be considered an alternative specific treatment for infant botulism when BabyBIG is not available.

scholarly journals The Cost Variability of Orthobiologics

2019 ◽  
Vol 12 (1) ◽  
pp. 94-98
Author(s):  
Amit Mukesh Momaya ◽  
Andrew Sullivan McGee ◽  
Alexander R. Dombrowsky ◽  
Alan Joshua Wild ◽  
Naqeeb M. Faroqui ◽  
...  
Keyword(s):  
United States ◽  
Sports Medicine ◽  
Platelet Rich Plasma ◽  
Treatment Options ◽  
The United States ◽  
Median Income ◽  
Level Of Evidence ◽  
Significant Variability ◽  
The Mean ◽  
The Cost

Background: Mixed results exist regarding the benefit of orthobiologic injections. The purpose of this study was to assess the variability in costs for platelet-rich plasma (PRP) and stem cell (SC) injections and evaluate for variables that influence pricing. Hypothesis: There will be significant variability in the cost of PRP and SC injections throughout the United States. Study Design: Descriptive epidemiology study. Level of Evidence: Level 3. Methods: Calls were made to 1345 orthopaedic sports medicine practices across the United States inquiring into the availability of PRP or SC knee injections and associated costs. In addition to pricing, the practice type, number of providers, and population and income demographics were recorded. Univariate statistical analyses were used to identify differences in availability and cost between variables. Results: Of the contacted offices that provided information on both PRP and SC availability (n = 1325), 268 (20.2%) offered both treatments, 550 (41.5%) offered only PRP injections, 20 (1.5%) offered only SC injections, and 487 (36.8%) did not offer either treatment. The mean ± SD cost of a PRP injection was $707 ± $388 (range, $175-$4973), and the mean cost of an SC injection was $2728 ± $1584 (range, $300-$12,000). Practices offering PRP and SC injections tended to be larger (PRP, 12.0 physicians per practice vs. 8.1 [ P < 0.001]; SC, 13.6 vs 9.7 [ P < 0.001]). Practices that offered PRP injections were located in areas with higher median household income ( P = 0.047). Variables associated with higher cost of PRP injections included city population ( P < 0.001) and median income of residents ( P < 0.001). Conclusion: While the majority of sports medicine practices across the United States offer some type of orthobiologic injection, there exists significant variability in the cost of these injections. Clinical Relevance: This study demonstrates the significant variability in costs of orthobiologic injections throughout the country, which will allow sports medicine physicians to appreciate the value of these injections when counseling patients on available treatment options.

The Cost of Surgical Site Infections after Colorectal Surgery in the United States from 2001 to 2012: A Longitudinal Analysis

2019 ◽  
Vol 85 (2) ◽  
pp. 142-149 ◽  
Author(s):  
Owen Gantz ◽  
Pavel Zagadailov ◽  
Aziz M. Merchant
Keyword(s):  
United States ◽  
Colorectal Surgery ◽  
Healthcare Cost ◽  
Surgical Site Infections ◽  
The United States ◽  
Cost Burden ◽  
National Inpatient Sample ◽  
Infection Rates ◽  
Surgical Interventions ◽  
The Cost

Surgical site infections (SSIs) are among the most common types of postoperative complications in the United States and are associated with significant prevalence of morbidity and mortality in patients undergoing surgical interventions, especially in colorectal surgery (CRS) where SSI rates are significantly higher than those of similar operative sites. SSIs were identified from the National Inpatient Sample-Healthcare Cost and Utilization Project database from 2001 to 2012 based on the specification of an ICD-9 code. Propensity score matching was used to compare costs associated with SSI cases with those of non-SSI controls among elective and nonelective admissions. Results were projected nationally using Healthcare Cost and Utilization Project sampling methodology to evaluate the incidence of SSIs and ascertain the national cost burden retrospectively. Among 4,851,359 sample-weighted hospitalizations, 4.2 per cent (203,597) experienced SSI. Elective admissions associated with SSI-stayed hospitalized for an average of 7.8 days longer and cost $18,410 more than their counterparts who did not experience an SSI. Nonelective admissions that experienced an SSI had an 8.5-day longer hospital stay and cost $20,890 more than counterparts without perioperative infections. This represents a 3 per cent annual growth in costs for SSIs and seems to be largely driven by cost increases in treatment of SSIs for elective surgeries. Current efforts of SSI management after CRS focused on compliance with guidelines and tracking of infection rates would benefit from some improvements. Considering the growing costs and increase in resource utilization associated with SSIs from 2001 to 2012, further research on costs associated with management of SSIs specific to CRS is necessary.

Admission trends in pediatric isolated linear skull fracture across the United States

2021 ◽  
pp. 1-13
Author(s):  
Alan R. Tang ◽  
Rebecca A. Reynolds ◽  
Jonathan Dallas ◽  
Heidi Chen ◽  
E. Haley Vance ◽  
...  
Keyword(s):  
United States ◽  
Skull Fracture ◽  
The United States ◽  
Rural Hospitals ◽  
Hospital Charges ◽  
National Database ◽  
Skull Fractures ◽  
Urban Teaching ◽  
Level Data ◽  
The Mean

OBJECTIVE Pediatric isolated linear skull fractures commonly result from head trauma and rarely require surgery, yet patients are often admitted to the hospital—a costly care plan. In this study, the authors utilized a national database to investigate trends in admission for skull fractures across the United States. METHODS Children younger than 18 years with isolated linear skull fracture, according to ICD-9 diagnosis codes in the Kids’ Inpatient Database of the Healthcare and Utilization Project (HCUP), who presented between 2003 and 2016 were included. HCUP collected data in 2003, 2006, 2009, 2012, and 2016. Children with a depressed skull fracture, multiple traumatic injuries, and acute intracranial findings were excluded. Sample-level data were translated into population-level data by using an HCUP-specific discharge weight. RESULTS Overall, 11,355 patients (64% males) were admitted to 1605 hospitals. National admissions decreased from 3053 patients in 2003 to 1203 in 2016. The mean ± SD age at admission also decreased from 6.3 ± 5.9 years to 1.2 ± 3.0 years (p < 0.001). The proportion of patients in the lowest quartile of median household income increased by 9%, while that in the highest income quartile decreased by 7% (p < 0.001). Admission was generally more common in the summer months (June, July, and August) and on weekdays (68%). The mean ± SD hospital length of stay decreased from 2.0 ± 3.1 days to 1.4 ± 1.4 days between 2003 and 2012, and then increased to 2.1 ± 6.8 days in 2016 (p < 0.001). When adjusted for inflation, the mean total hospital charges increased from $13,099 to $21,204 (p < 0.001). The greatest proportion of admissions was in the South (35%), and the lowest was in the Northeast (17%). The proportion of patients admitted to large hospitals increased (59% to 72%, p < 0.001), which corresponded to a decrease in patients admitted to small hospitals (16% to 9%, p < 0.001). Overall, the total proportion of admissions to rural hospitals decreased by 6%, and that to urban teaching centers increased by 15% (p < 0.001). Since 2003, no child has undergone a neurosurgical procedure or died as an inpatient. CONCLUSIONS This study identified a general nationwide decrease in admissions for pediatric linear isolated skull fracture, but associated costs increased. Admissions became less common at smaller rural hospitals and more common at larger urban teaching hospitals. This patient population required no inpatient neurosurgical intervention after 2003.

scholarly journals The Cost Variability of Orthobiologics

2019 ◽  
Vol 7 (7_suppl5) ◽  
pp. 2325967119S0028
Author(s):  
Brent Ponce ◽  
Andrew McGee ◽  
Alex Dombrowsky ◽  
Raymond Waldrop ◽  
Joshua Wild ◽  
...  
Keyword(s):  
United States ◽  
Stem Cell ◽  
Sports Medicine ◽  
Platelet Rich Plasma ◽  
The United States ◽  
City Population ◽  
The Mean ◽  
Cost Variability ◽  
The Cost ◽  
Mean Cost

Objectives: Despite limited clinical data, many orthopedic practices offer orthobiologic injections. Such injections are not covered by insurance, and thus patients pay out of pocket for these treatments. The purpose of this study was to assess the variability in costs for platelet rich plasma (PRP) and stem cell (SC) injections across practices and evaluate for variables that influence pricing. Methods: A list of 1,345 orthopedic sports medicine practices across the United States was compiled. Calls were made inquiring into the availability of PRP or SC knee injections and associated costs. In addition to pricing, practice type (academic or private), number of providers, and population and income demographics were recorded. Univariate statistical analyses were used to identify differences in availability and cost between variables. Results: Of the contacted offices, 268 (20.2%) offered both treatments, 550 (41.5%) offered only PRP injections, 20 (1.5%) offered only stem cell injections, and 487 (36.2%) did not offer either treatment. The mean (± SD) cost of a PRP injection was $707 ± $388 (range, $175 to $4,973), and the mean cost of a SC injection was $2,728 ± $1,584 (range, $300 to $12,000). Practices offering PRP and SC injections tended to be larger (for PRP - 11.6 physicians per practice vs. 8.1, P<0.001; for SC - 12.3 vs. 9.7, P=0.006). In addition, practices that offered PRP injections were located in areas with higher mean income ($67,500 vs. $64,300, P=0.047). Variables associated with higher cost of PRP injection included city population (P<0.001) and mean income of residents (P<0.001). Conclusion: While the majority of sports medicine practices across the United States offer some type of orthobiologic injection, there exists significant variability in the cost of these injections. The cost for PRP injections is higher in practices located in highly populated areas and in areas with greater mean incomes.

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