title: The burden of rhinitis in a managed care organization.
abstract: BACKGROUND
  Rhinitis is a common health condition, but the extent of the burden in managed care organizations (MCOs) has not been well described.
  
  
  OBJECTIVE
  To compare medical utilization in a large MCO of patients (1) with vs without rhinitis and (2) with allergic (AR) vs nonallergic (NAR) rhinitis.
  
  
  METHODS
  Patients 4 years and older with 1 or more encounters with an International Classification of Diseases, Ninth Revision, code for rhinitis and patients treated for rhinitis but without a rhinitis encounter (rhinitis treatment-only group) were identified. Patients seen in allergy departments for rhinitis were categorized as having AR or NAR.
  
  
  RESULTS
  Of 1,726,084 patients continuously enrolled for all 4 study years, 29% had 1 or more encounters for rhinitis (15%) or were treated for rhinitis (14%). Compared with patients without rhinitis, those with rhinitis encounters were significantly more likely to have encounters for asthma (odds ratio [OR], 2.7), acute sinusitis (OR, 4.4), chronic sinusitis (OR, 15.2), conjunctivitis (OR, 1.5), acute otitis media (OR, 1.9), chronic otitis media (OR, 4.3), sleep apnea (OR, 3.4), and fatigue (OR, 2.0). Results for rhinitis treatment-only patients (n = 242,565) were generally similar to those for rhinitis encounter patients. NAR was diagnosed in 21% of patients, who were significantly more likely than patients with AR to undergo sinus radiology and nasal surgery; to receive diagnoses of sinusitis, otitis media, sleep apnea, and fatigue; and to receive medications for nonrespiratory conditions (P < .001).
  
  
  CONCLUSIONS
  Rhinitis was common in this large MCO. Patients with rhinitis, especially NAR, had significantly more respiratory and nonrespiratory comorbid conditions than did patients without rhinitis.
authors.affiliation: Department of Allergy, Kaiser Permanente Southern California, San Diego, California 92111, USA. michael.x.schatz@kp.org
authors.forename: Michael
authors.initials: M
authors.lastname: Schatz
authors.forename: Robert S
authors.initials: RS
authors.lastname: Zeiger
authors.forename: Wansu
authors.initials: W
authors.lastname: Chen
authors.forename: Su-Jau
authors.initials: SJ
authors.lastname: Yang
authors.forename: Marlo A
authors.initials: MA
authors.lastname: Corrao
authors.forename: Virginia P
authors.initials: VP
authors.lastname: Quinn
mesh_terms: D000293:Adolescent; D000328:Adult; D000367:Age Factors; D000368:Aged; D001249:Asthma / Q000453:epidemiology; D002648:Child; D015897:Comorbidity; D003231:Conjunctivitis / Q000453:epidemiology; D017281:Cost of Illness; D003695:Delivery of Health Care / Q000706:statistics & numerical data; D011307:Drug Prescriptions / Q000706:statistics & numerical data; D005221:Fatigue / Q000453:epidemiology; D005260:Female; D006279:Health Maintenance Organizations / Q000191:economics / Q000706:statistics & numerical data*; D006801:Humans; D008297:Male; D008329:Managed Care Programs / Q000191:economics / Q000706:statistics & numerical data*; D008875:Middle Aged; D010033:Otitis Media / Q000453:epidemiology; D015995:Prevalence; D012221:Rhinitis, Allergic, Perennial / Q000188:drug therapy / Q000453:epidemiology* / Q000628:therapy; D012737:Sex Factors; D012891:Sleep Apnea Syndromes / Q000453:epidemiology; D014481:United States / Q000453:epidemiology