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National Trends in Hospitalization Charges and Utilization of Oral and Maxillofacial Surgery for Cleft Lip and Palate Patients

Yida Cai BA, Bailyn Hogue BS, Cristin Coquillard MD, Sam Boas BS, Lesley Summerville BS, Marvin Nicoleau BA, Anand Kumar MD
Case Western Reserve University School of Medicine
2020-02-11

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: Patients with cleft lip and palate often require multiple maxillofacial and orthognathic surgeries, but utilization trends remain poorly understood. This study examined national trends in resource utilization and hospitalization charges associated with oral and maxillofacial surgeries for cleft lip and palate.

METHODS: 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 oral or maxillofacial procedures were included. Univariate and generalized linear models were used to examine associations between factors of interest, final adjusted hospitalization charge, and changes in factors over time.

RESULTS: 62,471 patients were diagnosed cleft lip or palate. 1292 (2.1%) received oral or maxillofacial surgery including osteoplasty of maxilla (879, 68.0%), genioplasty (30, 2.3%) and other facial bone repair and reconstruction (183, 14.2%). Procedure volume did not change significantly (p = 0.199). High procedure volume was associated with large bedsizes (p < 0.001), non-profit private hospitals (p < 0.001) and urban teaching hospitals (p < 0.001). Average total hospital charge was $61,157.47 (interquartile range: $33,099.62 – $72,180.56). Charges increased significantly (p = 0.042), with an average hospital stay of 2.54 days that did not change significantly (p = 0.693).

CONCLUSION: Oral and maxillofacial procedures for patients with cleft lip and palate center around large, urban teaching, and non-profit private hospitals. While length of stay and procedure volume was stable year to year, hospitalization charges rose significantly. Further studies are necessary to examine other factors contributing to increasing hospitalization charges.

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