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Existence of important variations in the United States in the treatment of pediatric mastoiditis.
Arch Otolaryngol Head Neck Surg. 2009 Jan; 135(1):28-32.AO

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+Show Affiliations

Department of Otolaryngology-Head and Neck Surgery, National Capitol Consortium,Washington, DC, USA.No affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article

Language

eng

PubMed ID

19153304

Citation

Acevedo, Jason L., et al. "Existence of Important Variations in the United States in the Treatment of Pediatric Mastoiditis." Archives of Otolaryngology--head & Neck Surgery, vol. 135, no. 1, 2009, pp. 28-32.
Acevedo JL, Lander L, Shah UK, et al. Existence of important variations in the United States in the treatment of pediatric mastoiditis. Arch Otolaryngol Head Neck Surg. 2009;135(1):28-32.
Acevedo, J. L., Lander, L., Shah, U. K., & Shah, R. K. (2009). Existence of important variations in the United States in the treatment of pediatric mastoiditis. Archives of Otolaryngology--head & Neck Surgery, 135(1), 28-32. https://doi.org/10.1001/archoto.2008.510
Acevedo JL, et al. Existence of Important Variations in the United States in the Treatment of Pediatric Mastoiditis. Arch Otolaryngol Head Neck Surg. 2009;135(1):28-32. PubMed PMID: 19153304.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Existence of important variations in the United States in the treatment of pediatric mastoiditis. AU - Acevedo,Jason L, AU - Lander,Lina, AU - Shah,Udayan K, AU - Shah,Rahul K, PY - 2009/1/21/entrez PY - 2009/1/21/pubmed PY - 2009/2/20/medline SP - 28 EP - 32 JF - Archives of otolaryngology--head & neck surgery JO - Arch Otolaryngol Head Neck Surg VL - 135 IS - 1 N2 - 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. SN - 1538-361X UR - https://www.unboundmedicine.com/medline/citation/19153304/Existence_of_important_variations_in_the_United_States_in_the_treatment_of_pediatric_mastoiditis_ L2 - https://jamanetwork.com/journals/jamaotolaryngology/fullarticle/10.1001/archoto.2008.510 DB - PRIME DP - Unbound Medicine ER -