Urologic diseases in North America project: Trends in resource utilization for urinary tract infections in children

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 utilization, 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.