The cause of cost in the management of odontogenic infections 1: a demographic survey and multivariate analysis.

PURPOSE

The purpose of this retrospective cohort study was to describe the demographics of patients with odontogenic infections and to evaluate the costs associated with the demographic, social, treatment, and hospital course variables in patients hospitalized for odontogenic infections.

MATERIALS AND METHODS

A retrospective chart review was conducted in patients admitted for odontogenic infections at Harborview Medical Center from July 1, 2001, through June 30, 2011.

RESULTS

In total, 318 patient charts were reviewed and included. The unsponsored portion of the patient population increased from 14.7-61.9% over the course of the study. The average hospital bill per patient in this study was $17,053. Of the $5,422,854 billed, only $1,528,869 was received by the hospital in payment for services rendered, equating to $3,893,985 in lost potential revenue. The variables location of treatment, length of stay, length of stay in the intensive care unit, additional use of the operating room, and antibiotic regimen accounted for 90.2% of the variation in the hospital bill.

CONCLUSION

Unsponsored patients constituting 61.9% of the patient population represent an enormous challenge for hospitals and providers. To maintain the standard of care for all patients and still be able to provide care to patients without insurance, county hospitals and academic institutions must seek to improve cost efficiency. The present findings reinforce the need to be vigilant about the decision to admit, take to the operating room, admit to an intensive care unit, and discharge to lower the costs to the patient, hospital, and society for the management of odontogenic infections.