Oral presentation at the Annual Meeting of the Triological Society, Las Vegas, NV, April 30, 2010.
Article first published online: 31 AUG 2010
Copyright © 2010 The American Laryngological, Rhinological, and Otological Society, Inc.
Volume 120, Issue 11, pages 2313–2321, November 2010
How to Cite
Dugar, D. R., Lander, L., Mahalingam-Dhingra, A. and Shah, R. K. (2010), Pediatric acute sinusitis: Predictors of increased resource utilization. The Laryngoscope, 120: 2313–2321. doi: 10.1002/lary.21152
The authors have no conflicts of interest to declare.
The authors have no financial disclosures for this article.
- Issue published online: 22 OCT 2010
- Article first published online: 31 AUG 2010
- Accepted manuscript online: 30 AUG 2010 12:00AM EST
- Manuscript Accepted: 13 JUL 2010
- Manuscript Received: 13 APR 2010
- Paranasal sinus;
- endoscopic sinus surgery;
- resource utilization;
- Level of Evidence: 2c.
To determine variations in resource utilization in the management of pediatric acute sinusitis.
Retrospective analysis of a publicly available national dataset.
The Kids' Inpatient Database 2006 was analyzed using ICD-9codes for acute sinusitis.
A total of 8,381 patients (55% male, mean age 8.5 years [SE = 0.2]) were admitted with acute sinusitis. Mean total charges was $20,062 (SE = 1,159.1). Mean length of stay was 4.2 days (SE = 0.12), with 4.8 diagnoses (SE = 0.06) and 0.85 procedures (SE = 0.06). Thirty-six percent had concomitant respiratory diseases, 11% otitis media, and 8% orbital symptoms. A total of 703 patients underwent operations on the upper aerodigestive tract (534 were nasal sinusectomies); 582 patients underwent lumbar puncture and 162 underwent orbital surgery. The primary payer was private insurance in 50% and Medicaid in 41%. Predictors of increased total charges were male gender (P =.028), being a teaching hospital (P < .0001), metropolitan patient location (P < .0001), hospitals in the western region (P < .0001), admission source from another hospital (P < .0001), and discharge status to another inpatient hospital or home healthcare (P < .0001). There is a large geographic variation in resource utilization (range = $5,837 [Arkansas] to $48,327 [California]). Race, primary payer, admission type, and urgency were not significant predictors of increased resource utilization.
Despite being a common diagnosis, there exists a large national variation in management of acute pediatric sinusitis. Predictors of increased resource utilization included male gender, teaching hospital status, metropolitan patient location, western hospital region, admission source, and discharge status. Knowledge of these variables may allow interventions and potentially facilitate benchmarking to reduce the economic burden of this entity while ensuring optimal outcomes. Laryngoscope, 2010