UROLOGIC DISEASES IN NORTH AMERICA PROJECT: TRENDS IN RESOURCE UTILIZATION FOR URINARY TRACT INFECTIONS IN

Purpose: We evaluated the health utilization and economic burden on society of urinary tract infections (UTIs) in children using a variety of public and commercial health care databases. Materials and Methods: Numerous available databases were evaluated for health care utili-zation, including inpatient hospitalization, and outpatient physician and emergency department visits, by children with a coded diagnosis of urinary tract infection. Utilization was analyzed by age, gender, race, insurance type and geographic location, and trends were assessed during the last decade. Results: UTIs resulted in more than 1.1 million physician visits annually, accounting for 0.7% of doctor visits and occurring in 2.4 % to 2.8 % of children. Overall, inpatient hospitalization decreased slightly, although pyelonephritis still accounted for more than 13,000 admissions. Infants were more likely to receive inpatient care for UTIs than children or adolescents, although hospital costs were higher in adolescents. Inpatient hospital costs are estimated to be greater than 180 million dollars per year. Conclusions: Pediatric UTIs constitute a significant health burden on society. Available data do not allow a full accounting of costs due to a lack of information regarding outpatient expenses, as well as the cost of ancillary evaluation and treatment. However, the magnitude of the burden suggests the importance of further research and data collection of health care utilization in the pediatric population. KEY WORDS: urinary tract infections, pediatrics, pyelonephritis, cystitis, utilization review Urinary tract infections (UTIs) occur commonly during childhood, affecting an estimated 2.6 % to 3.4 % of children every year. Throughout childhood the risk of UTI is 2 % for boys and 8 % for girls.1 Yet little is known of the societal burden of pediatric UTIs in human and financial terms. As part of the larger Urologic Diseases in America project, avail-able health utilization databases were analyzed to assess the current public burden as well as the trends in utilization and cost during the last decade