Costs and Charges for Pediatric Tonsillectomy in New York State

Objective In this study, we aimed to determine the correlation between costs/charges related to admissions for pediatric tonsillectomy in New York State (NYS) and variables including discharge year, All Patient Refined (APR) severity of illness, length of hospital stay, payment typology, location, race, and institutional factors during 2009-2017. Methods Data were extracted from the Statewide Planning and Research Cooperative System (SPARCS) Hospital Inpatient Discharges database developed by the NYS Department of Health. Statistical analysis was employed to determine multiple linear regression coefficients with the costs and charges set as the dependent variable. Results Costs increased by an estimated $230.73 (p<.001) each year, and charges increased by an estimated $1,231.41 (p<.001) annually. For each categorical increase in severity of illness, costs increased by $1,019.21 (p<.001), and charges increased by $3,088.41 (p<.001). For each day spent in the hospital, costs increased by $3,539.23 (p<.001), and charges increased by $8,908.01 (p<.001). Unspecified managed care had the highest mean costs and charges (p<.001). Bronx County had the highest costs, and Queens County had the highest charges. Queens County demonstrated the largest gap between costs and charges. Conclusion This study revealed that the costs and charges related to admissions for elective tonsillectomy had risen from 2009 to 2017, and these changes were not accounted for by inflation alone. We found that the costs and charges for inpatient pediatric tonsillectomy were significantly correlated with discharge year, APR severity of illness, length of hospital stay, location of the hospital, and primary payer.