Existence of important variations in the United States in the treatment of pediatric mastoiditis.

Abstract

OBJECTIVE:

To determine national variations in resource utilization in the treatment of pediatric mastoiditis.

DESIGN:

Retrospective review.

SETTING:

National pediatric inpatient database.

PATIENTS:

The Kids' Inpatient Database for 2003 was used to extract data for admissions for mastoiditis.

RESULTS:

A total of 1049 patients (57% were male, and the mean age was 6.3 years) were identified. Median total charges for an admission were $9600; total charges were less than $28,604 in 90% of admissions. The mean length of stay (LOS) was 4.3 days (range, 0-87 days). A total of 792 procedures were performed; 50.0% of patients underwent tympanostomy tube placement and/or myringocentesis, and 21.6% underwent mastoidectomy. The LOS for nonsurgical patients was 3.7 days. The LOS for children undergoing tube placement was 4.6 days, with mean total charges of $15,713; for mastoidectomy, the LOS was 5.5 days, with mean total charges of $23,185. The primary payer was private insurance in 51.5% and Medicaid in 39.4%. Predictors of increased charges were treatment at teaching hospitals (P = .005), treatment at children's hospitals (P < .001), LOS (P < .001), the number of procedures (P < .001), and hospital region (P = .003). Wide geographic variation was noted with respect to the mean total charges per admission, which ranged from $5016 to $35,898.

CONCLUSIONS:

In 2003, the median charge for a pediatric mastoiditis admission was $9600; 50% of patients underwent tympanostomy tube placement, and about 21.6% underwent a mastoidectomy. There was wide variation in total charges for admissions. Resource utilization was higher in teaching hospitals and in children's' hospitals.

• Authors: Jason L Acevedo, Lina Lander, Udayan K Shah, Rahul K Shah
• Journal: Archives of otolaryngology--head & neck surgery (Arch Otolaryngol Head Neck Surg) Vol. 135 Issue 1 Pg. 28-32 (Jan 2009) ISSN: 1538-361X [Electronic] United States
• PMID: 19153304 (Publication Type: Journal Article)

Topics

• Child
• Costs and Cost Analysis
• Female
• Health Services (economics, statistics & numerical data)
• Hospital Charges (statistics & numerical data)
• Hospitalization (economics, statistics & numerical data)
• Hospitals, Pediatric (economics)
• Hospitals, Teaching (economics)
• Humans
• Length of Stay (economics, statistics & numerical data)
• Male
• Mastoiditis (economics, epidemiology, surgery)
• Middle Ear Ventilation (economics, methods)
• Otorhinolaryngologic Surgical Procedures (economics, methods, statistics & numerical data)
• Patient Admission (economics, statistics & numerical data)
• Retrospective Studies
• United States (epidemiology)