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Epidemiology and resource utilization in pediatric facial fractures.
J Surg Res. 2016 Feb; 200(2):648-54.JS

Abstract

BACKGROUND

Pediatric facial fractures, although uncommon, have a significant impact on public health and the US economy by the coexistence of other injuries and developmental deformities. Violence is one of the most frequent mechanisms leading to facial fracture. Teaching hospitals, while educating future medical professionals, have been linked to greater resource utilization in differing scenarios. This study was designed to compare the differences in patient characteristics and outcomes between teaching and non-teaching hospitals for violence-related pediatric facial fractures.

METHODS

Using the 2000-2009 Kids' Inpatient Database, 3881 patients younger than 18 years were identified with facial fracture and external cause of injury code for assault, fight, or abuse. Patients admitted at teaching hospitals were compared to those admitted at non-teaching hospitals in terms of demographics, injuries, and outcomes.

RESULTS

Overall, 76.2% of patients had been treated at teaching hospitals. Compared to those treated at non-teaching hospitals, these patients were more likely to be younger, non-white, covered by Medicaid, from lower income zip codes, and have thoracic injuries; but mortality rate was not significantly different. After adjusting for potential confounders, teaching status of the hospital was not found as a predictor of either longer lengths of stay (LOS) or charges.

CONCLUSIONS

There is an insignificant difference between LOS and charges at teaching and non-teaching hospitals after controlling for patient demographics. This suggests that the longer LOS observed at teaching hospitals is related to these institutions being more often involved in the care of underserved populations and patients with more severe injuries.

Authors+Show Affiliations

Division of Plastic Surgery, Indiana University School of Medicine, Indianapolis, Indiana.Division of Plastic Surgery, Indiana University School of Medicine, Indianapolis, Indiana.Division of Plastic Surgery, Indiana University School of Medicine, Indianapolis, Indiana.Division of Plastic Surgery, Indiana University School of Medicine, Indianapolis, Indiana.Division of Plastic Surgery, Indiana University School of Medicine, Indianapolis, Indiana. Electronic address: stholpad@iupui.edu.

Pub Type(s)

Comparative Study
Journal Article

Language

eng

PubMed ID

26541684

Citation

Soleimani, Tahereh, et al. "Epidemiology and Resource Utilization in Pediatric Facial Fractures." The Journal of Surgical Research, vol. 200, no. 2, 2016, pp. 648-54.
Soleimani T, Greathouse ST, Sood R, et al. Epidemiology and resource utilization in pediatric facial fractures. J Surg Res. 2016;200(2):648-54.
Soleimani, T., Greathouse, S. T., Sood, R., Tahiri, Y. H., & Tholpady, S. S. (2016). Epidemiology and resource utilization in pediatric facial fractures. The Journal of Surgical Research, 200(2), 648-54. https://doi.org/10.1016/j.jss.2015.10.004
Soleimani T, et al. Epidemiology and Resource Utilization in Pediatric Facial Fractures. J Surg Res. 2016;200(2):648-54. PubMed PMID: 26541684.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Epidemiology and resource utilization in pediatric facial fractures. AU - Soleimani,Tahereh, AU - Greathouse,Shawn Travis, AU - Sood,Rajiv, AU - Tahiri,Youssef H, AU - Tholpady,Sunil S, Y1 - 2015/10/12/ PY - 2015/06/01/received PY - 2015/08/21/revised PY - 2015/10/01/accepted PY - 2015/11/7/entrez PY - 2015/11/7/pubmed PY - 2016/5/11/medline KW - Facial fractures KW - Mandibular fracture KW - Pediatric KW - Resource utilization KW - Teaching hospital KW - Violence SP - 648 EP - 54 JF - The Journal of surgical research JO - J Surg Res VL - 200 IS - 2 N2 - BACKGROUND: Pediatric facial fractures, although uncommon, have a significant impact on public health and the US economy by the coexistence of other injuries and developmental deformities. Violence is one of the most frequent mechanisms leading to facial fracture. Teaching hospitals, while educating future medical professionals, have been linked to greater resource utilization in differing scenarios. This study was designed to compare the differences in patient characteristics and outcomes between teaching and non-teaching hospitals for violence-related pediatric facial fractures. METHODS: Using the 2000-2009 Kids' Inpatient Database, 3881 patients younger than 18 years were identified with facial fracture and external cause of injury code for assault, fight, or abuse. Patients admitted at teaching hospitals were compared to those admitted at non-teaching hospitals in terms of demographics, injuries, and outcomes. RESULTS: Overall, 76.2% of patients had been treated at teaching hospitals. Compared to those treated at non-teaching hospitals, these patients were more likely to be younger, non-white, covered by Medicaid, from lower income zip codes, and have thoracic injuries; but mortality rate was not significantly different. After adjusting for potential confounders, teaching status of the hospital was not found as a predictor of either longer lengths of stay (LOS) or charges. CONCLUSIONS: There is an insignificant difference between LOS and charges at teaching and non-teaching hospitals after controlling for patient demographics. This suggests that the longer LOS observed at teaching hospitals is related to these institutions being more often involved in the care of underserved populations and patients with more severe injuries. SN - 1095-8673 UR - https://www.unboundmedicine.com/medline/citation/26541684/Epidemiology_and_resource_utilization_in_pediatric_facial_fractures_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S0022-4804(15)00950-6 DB - PRIME DP - Unbound Medicine ER -