Economic Burden of the Stages of Pediatric CKD on the US Healthcare System

Abstract

Pediatric chronic kidney disease (CKD) plays a role in burdening the public health system. Some of this burden can be attributed to comorbidities frequently associated with CKD; however, much of the economic burden is attributed to CKD itself. The economic burden of CKD is difficult to estimate due to variability in the reporting of costs in the literature. In addition, few studies have endeavored to estimate the cost of CKD in the pediatric population, as CKD is not commonly diagnosed in children until the symptoms are observed. Therefore, we extracted data from The Pediatric Health Information System Database (PHIS) to evaluate if the length of stay, hospitalization cost, morbidity, and mortality is higher in patients with CKD than in patients without CKD and to determine if these variables increase over the CKD stage. We found that length of stay (LOS) and hospitalization costs are increased relative to a typical hospitalization. The LOS for patients with CKD 4 and CKD 5 were 22% and 50% longer relative to the LOS of a typical hospitalization, and the cost for these hospitalizations was 128% and 163% higher than that of a typical hospitalization. Morbidity and mortality remain constant through the various stages of CKD. Further investigation is imperative to decrease the financial burden on both patients and the US healthcare system.