Outpatient management of UTI as a treatment option was firmly established by Hoberman's study in 1999 and confirmed in Cochrane reviews in 2003 and 2007. However, UTI remains a common cause of pediatric hospitalization (ninth in 2006 excluding newborn and psychiatric diagnoses). Our objective was to look at national trends in UTI hospitalizations.
We examined the Kids' Inpatient Database (KID) and Nationwide Inpatient Sample (NIS), national datas ets available through AHRQ, from 1997 to 2006, through HCUPnet. NIS data are annual, and KID data are triennial. Hospitalization rates for DRG 599.0 were examined for trends across years. Changes in length of stay (LOS) and costs were also examined.
Hospitalization rates did not change significantly over the study period, varying between 23,056 and 25,499 annual discharges with rates of 46.8–51.2 per 100,000 population. LOS decreased by 14%, from 3.6 days in 1997 to 3.1 days in 2006 (P < 0.0001) — see Table 1. Costs have increased significantly, even adjusted for the Consumer Price Index, from $5616 in 1997 to $10,520 in 2006 (P < 0.0001) — see Table 2.
Despite the emergence of clear evidence that UTI can often be managed successfully on an outpatient basis, hospi‐talization rates and total discharges have not changed. The decreased LOS over the study period was offset by increased costs, making UTI more costly than ever, The existence of strong evidence‐based data that contradict previous, long‐standing assumptions seems not to have made an impact on current practice nationally. Further study needs to be done to explain causes of substantially increased costs for a disease for which treatment had not been dramatically altered over the study period.
D. Rauch, Baxter, Consultant.
To cite this abstract:Rauch D, Liu Y. National Trends of UTI Hospitalizations. Abstract published at Hospital Medicine 2009, May 14-17, Chicago, Ill. Abstract 80. Journal of Hospital Medicine. 2009; 4 (suppl 1). https://www.shmabstracts.com/abstract/national-trends-of-uti-hospitalizations/. Accessed July 16, 2019.