Allareddy Veerasathpurush, Turkistani Khadijah, Nanda Vikrum, Allareddy Veeratrishul, Gajendrareddy Praveenkumar, Venugopalan Shankar R
Predoctoral Orthodontics, Department of Developmental Biology, Harvard School of Dental Medicine, Boston, MA 02115, USA.
J Oral Maxillofac Surg. 2012 Aug;70(8):1968-77. doi: 10.1016/j.joms.2011.07.026. Epub 2011 Oct 19.
The objective of this study is to provide nationally representative estimates of cleft palate correction and revision procedures performed in hospitalized patients, as well as to examine patient- and hospital-level factors associated with hospitalization charges.
The Nationwide Inpatient Sample for the year 2007 was used. All hospitalizations that had a cleft palate correction or revision of cleft palate repair were selected. Estimates of concomitant procedures performed during the index hospitalization were obtained. The roles of different patient- and hospital-level variables on hospitalization charges were examined by use of multivariable linear regression analysis.
A total of 5,969 repairs and/or revisions of cleft palate procedures were performed in hospitals in the entire United States. The mean age per hospitalization was 3.2 years. Whites accounted for 51.3% of procedures, whereas blacks, Hispanics, Asian/Pacific Islanders, Native Americans, and other races accounted for 4.9%, 26.4%, 9.2%, 3.2%, and 5%, respectively. The mean charge per each hospitalization was $19,227, and the total hospitalization charge for the entire United States was $112.96 million. Patients aged less than 1 year (P = .02) and those aged between 8 and 12 years (P = .03) had significantly lower charges compared with those aged 18 years or older. Use of bone morphogenetic protein was associated with higher hospital charges (P = .0006). Compared with the uninsured, those covered by Medicaid (P = .04), private insurance plans (P = .02), and other insurance plans (P = .0005) were associated with higher charges.
This study identified an association between hospital charges and insurance payer, race, treatments performed, and age. Our results provide insights into nationally representative estimates on management of cleft palate corrections and revisions.
本研究的目的是提供全国范围内住院患者腭裂修复及翻修手术的代表性估计数据，并探讨与住院费用相关的患者及医院层面因素。
使用2007年全国住院患者样本。选取所有进行腭裂修复或腭裂修复翻修的住院病例。获取了索引住院期间进行的伴随手术的估计数据。通过多变量线性回归分析研究不同患者及医院层面变量对住院费用的作用。
在美国各地医院共进行了5969例腭裂修复和/或翻修手术。每次住院的平均年龄为3.2岁。白人占手术病例的51.3%，而黑人、西班牙裔、亚太岛民、美洲原住民和其他种族分别占4.9%、26.4%、9.2%、3.2%和5%。每次住院的平均费用为19227美元，美国全国的住院总费用为1.1296亿美元。年龄小于1岁（P = 0.02）和8至12岁（P = 0.03）的患者费用显著低于18岁及以上患者。使用骨形态发生蛋白与较高住院费用相关（P = 0.0006）。与未参保者相比，医疗补助（P = 0.04）、私人保险计划（P = 0.02）和其他保险计划（P = 0.0005）覆盖者的费用较高。
本研究确定了住院费用与保险支付方、种族、所进行的治疗及年龄之间的关联。我们的结果为腭裂修复及翻修管理的全国代表性估计提供了见解。
