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dc.contributor.authorRoberts, Alexa
dc.creatorRoberts, Alexa
dc.date.accessioned2019-07-20T02:32:43Z
dc.date.available2019-07-20T02:32:43Z
dc.date.issued2019
dc.identifier.urihttp://hdl.handle.net/10150/633449
dc.descriptionA Thesis submitted to The University of Arizona College of Medicine - Phoenix in partial fulfillment of the requirements for the Degree of Doctor of Medicine.
dc.description.abstractCentruroides F(ab’)2 antivenom (AV) is a safe and effective treatment for bark scorpion envenomation; however, concern exists regarding the substantial charges associated with this therapy and resulting unexpected costs of treatment. This retrospective review seeks to quantitate patient charges associated with antivenom use to better understand its impact on patient and healthcare economics. This is a retrospective review of 527 patients presenting to a hospital system with severe scorpion envenomation between April 2013 and May 2015. Included patients had Centruroides scorpion envenomation and received AV. They were excluded if they were not a grade III or IV envenomation, did not receive antivenom or their clinical records were not available. Patient charges and hospital costs were acquired from institutional financial records and were included if total costs were accurate as defined by costs > $2500. Clinical manifestations, length of stay (LOS), method and amount of AV administration were abstracted. Continuous data were reported as medians with interquartile range and linear regression was utilized to determine predictors of outcomes. All patients had a grade 3 or 4 envenomation and received AV. The total number of vials received were 1 (18.2%) to a maximum of 7 (0.4%) with most patients receiving three vials (46.7%). Most patients received three vials of antivenom initially (52.6%) as compared to one vial (43.6%) and only few receiving two vials (3.8%). Median total charges were $28,060 ($18,805 - $33,742). Linear regression showed that total charges were predicted by total number of vials administered and LOS (adjusted R2 of 0.75). Charges of care were found to increase by $7901.59 per vial of AV and by $415.48 for each hour of LOS. The only predictors of total charges were age, number of vials and total length of stay. Correlation between total charges and costs was poor. Despite established safety and efficacy, anticipated patient charges appear to influence the manner in which bark scorpion antivenom is administered by healthcare providers.
dc.language.isoen
dc.publisherThe University of Arizona.
dc.rightsCopyright © is held by the author. Digital access to this material is made possible by the College of Medicine - Phoenix, University of Arizona. Further transmission, reproduction or presentation (such as public display or performance) of protected items is prohibited except with permission of the author.
dc.subjectToxicology
dc.subjectToxicology
dc.subjectEnvenomation
dc.subjectArizona
dc.subject.meshEmergency Medicine
dc.titleHealthcare Charges Incurred from Scorpion Envenomation Treated with Centruroides F(ab’)2 Antivenom
dc.typetext
dc.typeElectronic Thesis
dc.contributor.departmentThe University of Arizona College of Medicine – Phoenix
dc.description.collectioninformationThis item is part of the College of Medicine - Phoenix Scholarly Projects 2019 collection. For more information, contact the Phoenix Biomedical Campus Library at pbc-library@email.arizona.edu.
dc.contributor.mentorO'Connor, Ayrn
refterms.dateFOA2019-07-20T02:32:43Z


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