Jonathan M Carnino, Amos M Mwaura, Henry Bayly, Lindsay R Salvati, Iman S Iqbal, Dean G Kennedy, Jessica R Levi
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Abstract
Purpose: This study investigates the impact of patient characteristics and demographics on hospital charges for tonsillectomy as a treatment for pediatric obstructive sleep apnea (OSA). The aim is to identify potential disparities in hospital charges and contribute to efforts for equitable access to care.
Methods: Data from the 2016 Healthcare Cost and Utilization Project (HCUP) Kid Inpatient Database (KID) was analyzed. The sample included 3,304 pediatric patients undergoing tonsillectomy ± adenoidectomy for OSA. Variables such as age, race, length of stay, hospital region, residential location, payer information, and median household income were collected. The primary outcome variable was hospital charge. Statistical analyses, including t-tests, ANOVA, and multiple linear regression, were conducted.
Results: Among 3,304 pediatric patients undergoing tonsillectomy for OSA. The average total charges for tonsillectomy were $26,400, with a mean length of stay of 1.70 days. Significant differences in charges were observed based on patient race, hospital region, and payer information. No significant differences were found based on gender, discharge quarter, residential location, or median household income. Multiple linear regression showed race, hospital region, and residential location were significant predictors of total hospital charges.
Conclusion: This study highlights the influence of patient demographics and regional factors on hospital charges for pediatric tonsillectomy in OSA cases. These findings underscore the importance of addressing potential disparities in healthcare access and resource allocation to ensure equitable care for children with OSA. Efforts should be made to promote fair and affordable treatment for all pediatric OSA patients, regardless of their demographic backgrounds.
目的：本研究调查了患者特征和人口统计学特征对扁桃体切除术治疗小儿阻塞性睡眠呼吸暂停（OSA）住院费用的影响。目的是确定医院收费中可能存在的差异，并为公平获得医疗服务做出贡献：对2016年医疗成本与利用项目（HCUP）儿童住院患者数据库（KID）中的数据进行了分析。样本包括3304名因OSA接受扁桃体切除术±腺样体切除术的儿科患者。收集的变量包括年龄、种族、住院时间、医院所在地区、居住地、付款人信息和家庭收入中位数。主要结果变量为住院费用。统计分析包括 t 检验、方差分析和多元线性回归：结果：在 3,304 名因 OSA 而接受扁桃体切除术的儿科患者中，扁桃体切除术的平均总费用为 1,090,000 美元。扁桃体切除术的平均总费用为 26,400 美元，平均住院时间为 1.70 天。根据患者的种族、医院所在地区和付款人信息，观察到收费存在显著差异。性别、出院季度、居住地或家庭收入中位数无明显差异。多元线性回归显示，种族、医院所在区域和居住地是医院总费用的重要预测因素：本研究强调了患者人口统计学和地区因素对 OSA 小儿扁桃体切除术住院费用的影响。这些发现强调了解决医疗服务和资源分配中潜在差异的重要性，以确保为 OSA 患儿提供公平的医疗服务。应努力促进为所有小儿 OSA 患者提供公平且负担得起的治疗，无论其人口背景如何。
期刊介绍：
The journal Sleep and Breathing aims to reflect the state of the art in the international science and practice of sleep medicine. The journal is based on the recognition that management of sleep disorders requires a multi-disciplinary approach and diverse perspectives. The initial focus of Sleep and Breathing is on timely and original studies that collect, intervene, or otherwise inform all clinicians and scientists in medicine, dentistry and oral surgery, otolaryngology, and epidemiology on the management of the upper airway during sleep.
Furthermore, Sleep and Breathing endeavors to bring readers cutting edge information about all evolving aspects of common sleep disorders or disruptions, such as insomnia and shift work. The journal includes not only patient studies, but also studies that emphasize the principles of physiology and pathophysiology or illustrate potentially novel approaches to diagnosis and treatment. In addition, the journal features articles that describe patient-oriented and cost-benefit health outcomes research. Thus, with peer review by an international Editorial Board and prompt English-language publication, Sleep and Breathing provides rapid dissemination of clinical and clinically related scientific information. But it also does more: it is dedicated to making the most important developments in sleep disordered breathing easily accessible to clinicians who are treating sleep apnea by presenting well-chosen, well-written, and highly organized information that is useful for patient care.
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