title: Existence of important variations in the United States in the treatment of pediatric mastoiditis.
abstract: OBJECTIVE
  To determine national variations in resource utilization in the treatment of pediatric mastoiditis.
  
  
  METHODS
  Retrospective review.
  
  
  METHODS
  National pediatric inpatient database.
  
  
  METHODS
  The Kids' Inpatient Database for 2003 was used to extract data for admissions for mastoiditis.
  
  
  RESULTS
  A total of 1049 patients (57% were male, and the mean age was 6.3 years) were identified. Median total charges for an admission were $9600; total charges were less than $28,604 in 90% of admissions. The mean length of stay (LOS) was 4.3 days (range, 0-87 days). A total of 792 procedures were performed; 50.0% of patients underwent tympanostomy tube placement and/or myringocentesis, and 21.6% underwent mastoidectomy. The LOS for nonsurgical patients was 3.7 days. The LOS for children undergoing tube placement was 4.6 days, with mean total charges of $15,713; for mastoidectomy, the LOS was 5.5 days, with mean total charges of $23,185. The primary payer was private insurance in 51.5% and Medicaid in 39.4%. Predictors of increased charges were treatment at teaching hospitals (P = .005), treatment at children's hospitals (P < .001), LOS (P < .001), the number of procedures (P < .001), and hospital region (P = .003). Wide geographic variation was noted with respect to the mean total charges per admission, which ranged from $5016 to $35,898.
  
  
  CONCLUSIONS
  In 2003, the median charge for a pediatric mastoiditis admission was $9600; 50% of patients underwent tympanostomy tube placement, and about 21.6% underwent a mastoidectomy. There was wide variation in total charges for admissions. Resource utilization was higher in teaching hospitals and in children's' hospitals.
authors.affiliation: Department of Otolaryngology-Head and Neck Surgery, National Capitol Consortium,Washington, DC, USA.
authors.forename: Jason L
authors.initials: JL
authors.lastname: Acevedo
authors.forename: Lina
authors.initials: L
authors.lastname: Lander
authors.forename: Udayan K
authors.initials: UK
authors.lastname: Shah
authors.forename: Rahul K
authors.initials: RK
authors.lastname: Shah
mesh_terms: D002648:Child; D003365:Costs and Cost Analysis; D005260:Female; D006296:Health Services / Q000191:economics* / Q000706:statistics & numerical data*; D017722:Hospital Charges / Q000706:statistics & numerical data*; D006760:Hospitalization / Q000191:economics / Q000706:statistics & numerical data; D006776:Hospitals, Pediatric / Q000191:economics; D006784:Hospitals, Teaching / Q000191:economics; D006801:Humans; D007902:Length of Stay / Q000191:economics / Q000706:statistics & numerical data; D008297:Male; D008417:Mastoiditis / Q000191:economics / Q000453:epidemiology / Q000601:surgery; D008876:Middle Ear Ventilation / Q000191:economics* / Q000379:methods*; D013517:Otorhinolaryngologic Surgical Procedures / Q000191:economics / Q000379:methods / Q000706:statistics & numerical data; D010343:Patient Admission / Q000191:economics / Q000706:statistics & numerical data; D012189:Retrospective Studies; D014481:United States / Q000453:epidemiology