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Financial implications of pediatric outpatient renal biopsies: a single-center experience.

BACKGROUND
With improvements in technology, renal biopsies have become safer and could potentially be effectively carried out in the outpatient setting. The purpose of our study is to compare the safety and cost of performing outpatient versus inpatient renal biopsies at a single Northern California pediatric hospital.


METHODS
We retrospectively studied the records of patients who underwent renal biopsy at our hospital during the period June 2001 to June 2006. Patients who were admitted to the hospital were compared with those who underwent biopsy as outpatients and were observed postprocedure for 4 hours for complications.


RESULTS
54 patients underwent 60 biopsies as inpatients and 58 patients underwent 78 biopsies as outpatients. Two inpatients required intervention for bleeding. One patient in the outpatient group was readmitted for persistent gross hematuria that subsided without intervention, and another patient had an inadequate sample obtained. Considering physician, nursing and ancillary hospital charges for the inpatient stay, the difference in cost was US $4,133 per procedure.


CONCLUSIONS
Our study suggests that discharging patients after a 4-hour monitoring period is a safe practice in a select group of patients. This practice has profound financial advantages by reducing health care costs and potentially improves patient satisfaction.