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National Trends in Hospitalization Charges and Utilization of Services for Cleft Alveolar Repair
Yida Cai BA, Samuel Boas BS, Lesley Summerville BS, ScM, Robert Clark BS, Anand Kumar MD
Case Western Reserve University School of Medicine
2020-01-31
Presenter: Yida Cai
Affidavit:
I certify that the material proposed for presentation in this abstract has not been published in any scientific journal or previously presented at a major meeting. The program director is responsible for making a statement within the confines of the box below specific to how much of the work on this project represents the original work of the resident. All authors/submitters of each abstract should discuss this with their respective program director for accurate submission of information as well as the program director's approval for inclusion of his/her electronic signature.
Director Name: Anand Kumar MD
Author Category: Medical Student
Presentation Category: Clinical
Abstract Category: Craniomaxillofacial
Purpose: Patients with cleft lip and palate often receive alveolar cleft reconstruction, however, national utilization of these procedures are poorly understood. The purpose of this study was to examine national trends in utilization and hospitalization charges associated with cleft alveolar repair.
Methods/Description: The National Inpatient Sample database was analyzed from January 2007 to December 2014. All patients who were diagnosed with cleft lip or palate who underwent alveoloplasty, bone graft to the face, gingivoplasty or craniofacial fistula closure were included. Univariate and generalized linear models were used to analyze various factors of interest and the final adjusted hospitalization charge, as well as the change in these factors over the multiple years.
Results: 62,471 patients were diagnosed cleft lip or palate. 3,002 (4.8%) received alveoloplasty, bone graft to the face, gingivoplasty or craniofacial fistula closure. There was no significant change in procedure volume (p = 0.455). High procedure volume was associated with non-profit hospitals (p < 0.001), large bedsizes (p < 0.001) and urban teaching hospitals (p < 0.001). Average total hospital charge was $28,234.42 (interquartile range: $16,635.93 – $34,549.42). Charges increased significantly (p < 0.001), with a hospital length of stay of 1.12 days that did not change significantly (p = 0.125).
Conclusions: Utilization of services for cleft alveolar repair center around large, urban, teaching and non-profit private hospitals. While the demand and length of stay are stable year to year, hospitalization charges rose significantly. Further studies will be done to examine other factors driving the increasing hospitalization charges.
