Nationwide analysis of hospital-level disparities in peritonsillar abscess management

Peritonsillar abscess (PTA) is a common deep neck infection that can cause severe complications if untreated. While management strategies are well established, limited evidence exists on how hospital type, safety-net (SNH) versus non-safety-net hospitals (non-SNHs), affects treatment, readmissions, and outcomes. This study evaluated national PTA outcomes with a focus on hospital type and patient demographics.

We performed a retrospective cohort study using the 2020 HCUP National Readmission Database to identify PTA admissions and 30-day readmissions. Demographic, clinical, and hospital-level factors were analyzed, including length of stay (LOS) and charges. Comparisons were made between SNHs and non-SNHs.

Among 3915 admissions, the overall 30-day readmission rate was 4.9 % (n = 190). Patients under 25 years comprised 41.5 % of admissions and had higher readmission rates (5.2 %) compared with older patients. Readmissions did not differ by sex, insurance, or income quartile. Non-SNHs treated higher PTA volumes, while SNHs cared for more Medicaid and lower-income patients. Outcomes were similar across hospital types: mean LOS was slightly longer at SNHs (2.6 vs. 2.4 days, p = 0.04), and mean charges were higher at non-SNHs ($26,012 vs. $22,475, p < 0.01). Readmission rates were comparable (SNH 4.8 % vs. non-SNH 5.0 %, p = 0.71).

PTA management is consistent across hospital types, with no significant outcome differences between SNHs and non-SNHs. Younger patients had higher readmission risk, and cost disparities between hospital types highlight the need for further research on resource utilization and the role of tonsillectomy.