Lam John S, Breda Alberto, Schulam Peter G
Department of Urology, David Geffen School of Medicine at University of California-Los Angeles, Los Angeles, California 90095-1738, USA.
J Urol. 2007 May;177(5):1652-8. doi: 10.1016/j.juro.2007.01.056.
We quantified the burden of ureteropelvic junction obstruction in the United States by identifying trends in the use of health care resources and estimating the economic impact of the disease.
The analytical methods used to generate these results were described previously.
Inpatient hospitalization rates were highest in children younger than 3 years. Most patients were male and hospitalizations occurred almost exclusively at urban centers. Patients with a primary diagnosis of ureteropelvic junction obstruction between 1994 and 2000 had an overall decrease in the age adjusted rate of inpatient hospitalization from 1.1/100,000 to 0.8/100,000. Physician office visits by Medicare beneficiaries with ureteropelvic junction obstruction as the primary diagnosis showed stable overall age adjusted rates during the reported years. Between 1999 and 2003 mean inpatient length of stay and cost per child hospitalized with the primary diagnosis of ureteropelvic junction obstruction was 2.9 days and $7,728, respectively. Average length of stay decreased more for children than for adults but total inpatient spending remained stable at about $12 million.
The majority of ureteropelvic junction obstructions are diagnosed in the perinatal period. Surgical intervention for pediatric patients has decreased with time, while there has been an increasing trend toward the conservative management of this condition.
我们通过确定医疗保健资源使用趋势并估计该疾病的经济影响，对美国输尿管肾盂连接部梗阻的负担进行了量化。
用于得出这些结果的分析方法已在之前进行了描述。
3岁以下儿童的住院率最高。大多数患者为男性，且住院几乎都发生在城市中心。1994年至2000年间，以输尿管肾盂连接部梗阻为主要诊断的患者，年龄调整后的住院率总体上从1.1/100,000降至0.8/100,000。以输尿管肾盂连接部梗阻为主要诊断的医疗保险受益人的门诊就诊次数在报告年份期间总体年龄调整率保持稳定。1999年至2003年间，以输尿管肾盂连接部梗阻为主要诊断住院的儿童，平均住院天数和费用分别为2.9天和7728美元。儿童的平均住院天数降幅大于成人，但住院总费用保持稳定，约为1200万美元。
大多数输尿管肾盂连接部梗阻在围产期被诊断出来。随着时间的推移，儿科患者的手术干预有所减少，而对此病症的保守治疗有增加趋势。
