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Acute renal failure: cost-effectiveness analysis and expert probability predictions of prevention and treatment strategies

Durtschi, Amy J

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2003, Doctor of Philosophy, Ohio State University, Pharmacy.
OBJECTIVES: To estimate hospital costs and charges attributable to the development of acute renal insufficiency (ARI) and acute renal failure (ARF) after coronary artery bypass grafting (CABG). METHODS: A retrospective analysis of patients undergoing CABG at University of Pittsburgh Medical Center from June 1998 through May 2002 was conducted. Patients were matched with respect to severity of illness by APACHE III scores. A Wilcoxon signed-rank test was used to assess differences in costs and charges. RESULTS: There were 3741 total patients that resulted in 644 matched pairs. The mean and median hospital charges among cases were approximately $221,864 and $158,312 respectively. The mean and median hospital charges among controls were approximately $110,868 and $91,738 respectively. Distribution of the hospital charges were positively skewed (Shapiro-Wilk test, 0<0.001). The difference in median hospital charges was $66,500 (Wilcoxon signed-rank test, p<0.01). The mean and median hospital costs among cases were $44,180 and $28,901 respectively. The mean and median hospital costs among controls were $22,471 and $18,038 respectively. The difference in median hospital costs was $10,863 (Wilcoxon signed-rank test, p<0.01). The mean and median ICU costs among cases were $35,566 and $21,183 respectively. The mean and median ICU costs among controls were $17,634 and $13,655 respectively. The difference in median ICU costs was $7528 (Wilcoxon signed-rank test, p<0.01). CONCLUSIONS: Although patients were matched using APACHE III scores, a severity of illness scoring system, patients with ARI/ARF after CABG had significantly higher hospital and ICU costs and charges than patients without ARI/ARF. These differences can be attributed to the development of renal complications after CABG.
Dev Pathak (Advisor)
260 p.

Recommended Citations

Citations

  • Durtschi, A. J. (2003). Acute renal failure: cost-effectiveness analysis and expert probability predictions of prevention and treatment strategies [Doctoral dissertation, Ohio State University]. OhioLINK Electronic Theses and Dissertations Center. http://rave.ohiolink.edu/etdc/view?acc_num=osu1053700977

    APA Style (7th edition)

  • Durtschi, Amy. Acute renal failure: cost-effectiveness analysis and expert probability predictions of prevention and treatment strategies. 2003. Ohio State University, Doctoral dissertation. OhioLINK Electronic Theses and Dissertations Center, http://rave.ohiolink.edu/etdc/view?acc_num=osu1053700977.

    MLA Style (8th edition)

  • Durtschi, Amy. "Acute renal failure: cost-effectiveness analysis and expert probability predictions of prevention and treatment strategies." Doctoral dissertation, Ohio State University, 2003. http://rave.ohiolink.edu/etdc/view?acc_num=osu1053700977

    Chicago Manual of Style (17th edition)