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Geographic Variations in Healthcare Utilization and Expenditure for Chronic Rhinosinusitis: A Population-Based
David W Jang1, Hui Jie Lee2,3, Philip G Chen4
1Department of Head and Neck Surgery & Communication Sciences, Duke University, Durham, North Carolina, U.S.A.
The Laryngoscope
|April 27, 2021
Summary
Healthcare costs and resource use for chronic rhinosinusitis (CRS) vary significantly by geographic region. These variations persist even after accounting for patient factors, highlighting the need for targeted interventions.
Area of Science:
- Otolaryngology
- Health Services Research
- Epidemiology
Background:
- Chronic rhinosinusitis (CRS) represents a substantial healthcare burden in the United States.
- Understanding geographic variations in healthcare resource utilization (HCRU) and healthcare expenditure (HCE) for CRS is crucial for effective management.
- Previous research has not fully elucidated regional differences in CRS-related HCRU and HCE.
Purpose of the Study:
- To investigate and quantify geographic variations in HCRU and HCE among patients with CRS.
- To identify specific regional patterns in treatment modalities and healthcare utilization for CRS.
- To provide data for optimizing resource allocation and cost-saving strategies in CRS care.
Main Methods:
- A retrospective analysis of the IBM® Marketscan Research Databases (2013-2017) was conducted.
- Nearly 238,000 patients meeting CRS diagnostic criteria were included, with 1 year of pre-index and 2 years of post-index data.
- Multivariable generalized linear models were used to analyze HCRU and HCE across geographic regions, adjusting for demographics, medication use, and comorbidities.
Main Results:
- The South region showed the highest rates of antibiotic prescriptions, surgery, immunotherapy, and oral steroid use.
- The Northeast region had the highest mean HCE ($2,449) and the highest frequency of otolaryngologist visits.
- HCRU and HCE were consistently higher in urban areas compared to rural areas, with urban HCE being 18% greater.
- Significant geographic disparities in HCE were observed even after statistical adjustments.
Conclusions:
- Substantial geographic variations in HCRU and HCE for CRS exist, independent of patient-specific factors.
- These findings underscore the need for targeted quality improvement initiatives and efficient resource allocation strategies.
- Further research is warranted to address regional disparities and support value-based care models for CRS.
Keywords:
Chronic rhinosinusitisMarketscangeographic variationhealthcare utilizationpopulation healthMore Related Videos
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