Uncomplicated acute renal failure and hospital resource utilization: a retrospective multicenter analysis.
BACKGROUND
Although acute renal failure (ARF) complicating nonrenal organ dysfunction in the intensive care unit is associated with significant mortality and hospital costs, hospital resource utilization attributed to uncomplicated ARF is not well known. The goal of this study is to characterize the costs and lengths of stay (LOSs) incurred by hospitalized patients with uncomplicated ARF and their important determining factors.


METHODS
We obtained hospital case-mix data sets from 23 Massachusetts hospitals for a 2-year period (1999 to 2000) from the Massachusetts Division of Health Care Finance and Policy. A total of 2,252 records of patients hospitalized with uncomplicated ARF were identified. Patient records of other common medical diagnoses were studied for comparison.


RESULTS
Patients hospitalized with uncomplicated ARF incurred median direct hospital costs of 2,600 dollars, median hospital LOS of 5 days, and mortality of 8%. Dialysis was independently associated with significantly greater hospital costs and LOSs for patients with uncomplicated ARF (P < 0.05). Male sex and nonwhite race were associated with significantly lower hospital costs and LOSs, whereas type of hospital had opposing effects on these 2 resource utilization outcomes (P < 0.05). Unadjusted aggregate resource utilization associated with uncomplicated ARF exceeded that of many other common illnesses.


CONCLUSIONS
Demographic and hospital factors, as well as dialysis therapy, are significant determinants of hospital resource utilization for patients with uncomplicated ARF. Uncomplicated ARF appears to incur greater hospital costs and longer LOSs compared with other common medical conditions. Greater focus should be directed toward further understanding of the factors influencing resource utilization for ARF.
Fischer
Michael J
MJ
Department of Internal Medicine, University of Illinois Medical Center/Veterans Administration Medical Center, Chicago, IL, USA. fischerm@uic.edu
Brimhall
Bradley B
BB
Lezotte
Dennis C
DC
Glazner
Judith E
JE
Parikh
Chirag R
CR
D058186:Acute Kidney Injury / Q000191:economics* / Q000453:epidemiology; D000368:Aged; D000369:Aged, 80 and over; D015331:Cohort Studies; D003953:Diagnosis-Related Groups; D004636:Emergency Service, Hospital / Q000191:economics; D005006:Ethnicity / Q000706:statistics & numerical data; D005260:Female; D006295:Health Resources / Q000191:economics* / Q000706:statistics & numerical data; D017721:Hospital Costs / Q000706:statistics & numerical data*; D006761:Hospitals / Q000706:statistics & numerical data*; D006801:Humans; D007182:Income; D007362:Intensive Care Units / Q000191:economics* / Q000706:statistics & numerical data; D007902:Length of Stay / Q000191:economics; D008297:Male; D008404:Massachusetts / Q000453:epidemiology; D006278:Medicare / Q000706:statistics & numerical data; D012189:Retrospective Studies; D012720:Severity of Illness Index