TY - JOUR
T1 - Cost of management in epistaxis admission
T2 - Impact of patient and hospital characteristics
AU - Goljo, Erden
AU - Dang, Rajan
AU - Iloreta, Alfred M.
AU - Govindaraj, Satish
N1 - Publisher Copyright:
© 2015 The American Laryngological, Rhinological and Otological Society, Inc.
PY - 2015/12/1
Y1 - 2015/12/1
N2 - Objectives/Hypothesis To investigate patient and hospital characteristics associated with increased cost and length of stay in the inpatient management of epistaxis. Study Design Retrospective cross-sectional study of the 2008 to 2012 National (Nationwide) Inpatient Sample. Methods Patient and hospital characteristics of epistaxis admissions were analyzed. Multiple linear regression analysis was used to ascertain variables associated with increased cost and length of hospital stay. Variables significantly associated with high cost were further analyzed to determine the contribution of operative intervention and total procedures to cost. Results A total of 16,828 patients with an admitting diagnosis of epistaxis were identified. The average age was 67.5; 52.3% of the patients were male; 73.3% of the patients were Caucasian; and 70.7% of the hospital stays were government funded. The average length of stay was 3.24 days, and average hospitalization cost was $6,925. Longer length of stay was associated with black race, alcohol abuse, sinonasal disease, renal disease, Medicaid, and care at a northeastern U.S. hospital. Increased hospitalization costs of > $1,000 were associated with Asian/Pacific Islander race; sinonasal disease; renal disease; top income quartile; and care at urban teaching, northeastern, and western hospitals in the United States. High costs were predicted by procedural intervention in patients with comorbid alcohol abuse, sinonasal disease, renal disease, patients with private insurance, and patients managed at large hospitals. Conclusion Although hospitalization costs are complex and multifactorial, we were able to identify patient and hospital characteristics associated with high costs in the management of epistaxis. Early identification and intervention, combined with implementation of targeted hospital management protocols, may improve outcomes and reduce financial burden. Level of Evidence 2C.
AB - Objectives/Hypothesis To investigate patient and hospital characteristics associated with increased cost and length of stay in the inpatient management of epistaxis. Study Design Retrospective cross-sectional study of the 2008 to 2012 National (Nationwide) Inpatient Sample. Methods Patient and hospital characteristics of epistaxis admissions were analyzed. Multiple linear regression analysis was used to ascertain variables associated with increased cost and length of hospital stay. Variables significantly associated with high cost were further analyzed to determine the contribution of operative intervention and total procedures to cost. Results A total of 16,828 patients with an admitting diagnosis of epistaxis were identified. The average age was 67.5; 52.3% of the patients were male; 73.3% of the patients were Caucasian; and 70.7% of the hospital stays were government funded. The average length of stay was 3.24 days, and average hospitalization cost was $6,925. Longer length of stay was associated with black race, alcohol abuse, sinonasal disease, renal disease, Medicaid, and care at a northeastern U.S. hospital. Increased hospitalization costs of > $1,000 were associated with Asian/Pacific Islander race; sinonasal disease; renal disease; top income quartile; and care at urban teaching, northeastern, and western hospitals in the United States. High costs were predicted by procedural intervention in patients with comorbid alcohol abuse, sinonasal disease, renal disease, patients with private insurance, and patients managed at large hospitals. Conclusion Although hospitalization costs are complex and multifactorial, we were able to identify patient and hospital characteristics associated with high costs in the management of epistaxis. Early identification and intervention, combined with implementation of targeted hospital management protocols, may improve outcomes and reduce financial burden. Level of Evidence 2C.
KW - Epistaxis
KW - National Inpatient Sample
KW - Nationwide Inpatient Sample
KW - comorbidities
KW - cost
KW - hospitalization
UR - http://www.scopus.com/inward/record.url?scp=84936804959&partnerID=8YFLogxK
U2 - 10.1002/lary.25374
DO - 10.1002/lary.25374
M3 - Article
C2 - 26153109
AN - SCOPUS:84936804959
SN - 0023-852X
VL - 125
SP - 2642
EP - 2647
JO - Laryngoscope
JF - Laryngoscope
IS - 12
ER -