Rising costs despite declining resource utilization: Widening disparities in adolescent reduction mammaplasty

Area of Science:

• Plastic Surgery
• Health Economics
• Health Services Research

Background:

• Adolescent reduction mammaplasty volume has significantly increased.
• Inconsistent insurance policies often limit patient access.
• Longitudinal trends in costs, resource utilization, and surgical timing were examined.

Purpose of the Study:

• To analyze trends in costs and resource utilization for adolescent reduction mammaplasty.
• To identify predictors of cost and surgical timing in this patient population.
• To investigate disparities in access and cost based on insurance and demographics.

Main Methods:

• Retrospective cohort study using the Pediatric Health Information System database (2007-2025).
• Included female patients aged 10-21 years undergoing reduction mammaplasty.
• Analyzed inflation-adjusted total hospital costs and standardized resource utilization using multivariable models.

Main Results:

• Standardized resource utilization decreased annually (-0.3%), while hospital costs increased annually (0.3%).
• Cost inflation was concentrated among publicly insured and uninsured patients; private insurance costs remained stable.
• Black patients, those with chronic conditions, public insurance, and Hispanic ethnicity faced higher costs and longer surgical delays.

Conclusions:

• The economic burden of adolescent reduction mammaplasty has grown, driven by cost inflation.
• Cost increases disproportionately affect publicly insured and minority patients.
• Policy interventions are needed to address administrative barriers and reduce healthcare disparities.