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National Trends in Hospitalization Charges and Utilization of Services for Cleft Lip and Palate Repair

Yida Cai BA, Bailyn Hogue BS, Marvin Nicoleau BA, Sam Boas BS, Lesley Summerville BS, Anand Kumar MD
Case Western Reserve University School of Medicine
2020-02-09

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 submitted abstract represents the authors' original work.

Director Name: Anand Kumar MD

Author Category: Medical Student
Presentation Category: Clinical
Abstract Category: Craniomaxillofacial

Purpose: Understanding factors that influence hospitalization charges associated with surgical procedures and national trends in utilization of services can help target strategies to reduce healthcare spending and improve patient outcomes. This study examined national trends in utilization and hospitalization charges associated with cleft lip and palate repair.

Methods/Description: The Healthcare Cost and Utilization Project National Inpatient Sample database was analyzed from January 2007 to December 2014. All patients diagnosed with cleft lip or palate who underwent correction or repair were included. Univariate and generalized linear models were used to analyze associations between factors of interest, final adjusted hospitalization charge, and the change in these factors over time.

Results: 62,471 patients were diagnosed cleft lip or palate and 34,200 (54.7%) received repair. The overall volume of cleft lip and palate repairs decreased (p = 0.028). High procedure volume was associated with non-profit private hospitals (p < 0.001), large bedsizes (p < 0.001) and urban hospitals (p < 0.001). Mean total hospital charge was $26,879.58 (interquartile range: $15,464.90 – $32,020.12). Hospitalization charges increased significantly (p < 0.001) in conjunction with increased average length of stay (p < 0.001).

Conclusions: Utilization of services for cleft lip and palate repair center around large, urban, non-profit, private hospitals. The overall demand for these procedures decreased in conjunction with increasing associated charges and length of stay. Longer length of stay may contribute to increasing hospitalization charges and could be a target for strategies to decrease the overall healthcare burden and increase access to these procedures.

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