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

Yida Cai BA, Bailyn Hogue BS, Cristin Coquillard MD, Sam Boas BS, Lesley Summerville BS, 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

Background & Purpose: Patients with cleft lip and palate often require rhinoplasty for cleft nasal deformity. These are complex procedures requiring significant healthcare resources, but the national healthcare burden and utilization trends are poorly understood. This study examined national trends in utilization and hospitalization charges associated with cleft rhinoplasty over multiple years.

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 rhinoplasty were included. Univariate and generalized linear models were used to examine associations between factors of interest, final adjusted hospitalization charge, and the change in factors over time.

Results: 62,471 patients were diagnosed cleft lip or palate and 905 (1.4%) received rhinoplasty during hospitalization. Procedure volume increased significantly (p = 0.015). Higher procedure volume was associated with non-profit private hospitals (p < 0.001) and urban teaching hospitals (p < 0.001). Average total hospital charge was $33,248.21 (interquartile range: $19,369.16 – $40,585.97). Hospitalization charges increased significantly (p = 0.014) with an average hospital length of stay of 1.42 days that did not change significantly (p = 0.957).

Conclusions: Utilization of services for cleft rhinoplasty center around urban teaching and non-profit private hospitals. While length of stay was stable, procedure demand and charges rose significantly. Further studies will be done to examine other factors that could contribute to increased hospitalization charges, which will help reduce the healthcare burden and improve patient access to this procedure.

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