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Inpatient Pediatric Epistaxis: Management and Resource Utilization
Jonathan S Ni1, Jocelyn Kohn2, Jessica R Levi1,2
11 Boston University School of Medicine, Boston, Massachusetts, USA.
Insights
Pediatric epistaxis admissions incur significant charges despite rarely needing procedures or long hospital stays. Factors like admission source and household income influence costs, highlighting potential for improved resource use.
Area of Science:
- Pediatric Healthcare
- Health Economics
- Medical Informatics
Background:
- Epistaxis (nosebleeds) is common in children but rarely requires hospitalization.
- Inpatient management of pediatric epistaxis is not well-studied due to its rarity.
Purpose of the Study:
- Analyze national trends in pediatric epistaxis inpatient treatment.
- Identify factors influencing total healthcare charges for these admissions.
Main Methods:
- Utilized the 2012 Kids' Inpatient Database (KID) for weighted discharges with epistaxis as the primary diagnosis.
- Collected data on demographics, comorbidities, treatments, and hospital burden.
- Employed linear regression to analyze cost-influencing factors.
Main Results:
- Analyzed 372 weighted discharges; mean age 9.68 years, 60% male.
- Common comorbidities included thrombocytopenia, von Willebrand disease, and chronic sinusitis.
- 56.7% of admissions did not undergo epistaxis control procedures; mean charges were $30,208.
- Longer length of stay, emergency department admission, and higher household income predicted increased charges.
- Midwest hospital region predicted decreased charges; procedures did not significantly impact cost.
Conclusions:
- Pediatric epistaxis hospitalizations often do not necessitate lengthy stays or procedural interventions.
- Substantial healthcare charges are associated with inpatient epistaxis treatment.
- Understanding cost drivers can optimize resource allocation and management strategies.
Objectives:
Epistaxis is a common condition that rarely warrants hospital admission in the pediatric population, making its inpatient management difficult to study. This study aims to use a nationwide database to analyze trends in the treatment of pediatric patients admitted with epistaxis and determine factors impacting total charges.
Methods:
The latest (2012) version of the Kids' Inpatient Database (KID), Healthcare Cost and Utilization Project (HCUP), Agency for Healthcare Research and Quality was used to identify weighted discharges with the primary diagnosis of epistaxis. Information regarding demographics, comorbidities, treatment, hospital burden, and other admission details were obtained. Linear regression was used to analyze factors suspected to increase cost.
Results:
Among 372 weighted discharges, the mean age was 9.68 years (SD = 5.79), and 60.0% were male. The most common comorbidities were thrombocytopenia, von Willebrand disease, and chronic sinusitis. The majority of admissions with epistaxis (56.7%) did not undergo any procedure to control epistaxis. Mean total charges was $30 208 (SD = $62 683) with a mean length of stay of 2.46 days (SD = 3.31). Independent predictors of increased charges included longer length of stay, admission from the emergency department, and median household income within the third quartile for patients' ZIP codes. Midwest hospital region independently predicted decreased charges. Having a procedure to control epistaxis did not significantly impact cost.
Conclusions:
Pediatric epistaxis admissions often do not require long hospital stays or procedural control of the bleed. However, significant charges are incurred treating epistaxis. Awareness of factors impacting these charges can potentially improve resource utilization.
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