title: Economics of facial fracture reductions in the United States over 12 months.
abstract: OBJECTIVE
  The face is a complex architectural structure in the body and is a high-risk site for fractures. Hospitalization is necessary for adequate treatment. The objective of this study is to examine hospitalization outcomes associated with reduction in facial fractures in the United States.
  
  
  METHODS
  The Nationwide Inpatient Sample (NIS) of the health care cost and utilization project for 2008 was used. This database provides weighted estimates of all hospitalizations in the United States, which approximates 39.88 million admissions in the entire United States. Hospital discharges with primary procedure ICD-9-CM codes for reduction in facial fractures were selected. Outcomes examined included hospitalization charges, length of stay, and causes of injuries. All estimates obtained from the sample were projected to national levels.
  
  
  RESULTS
  Reduction in facial fractures was performed as primary procedure in 21,244 hospitalizations. The total hospitalization charges were about $1.06 billion, and total hospitalization days was 93,808. About 80% of all hospitalizations occurred among men. The frequently occurring external causes of injuries leading to hospitalization for reduction in facial fractures include assault (36.5% of all hospitalizations), motor vehicle traffic accidents (16%), falls (15%), and other transportation accidents (3.5%). The frequently performed procedures were open reduction in mandibular fractures (52.2%), open reduction in facial fractures including those of orbital rim or wall (14.7%), closed reduction in mandibular fractures (12.1%), and open reduction in malar and zygomatic fractures (11.8%).
  
  
  CONCLUSIONS
  National hospitalization outcomes related to reduction in facial fractures indicate an extensive consumption of hospital resources. If hospital emergency room protocols and inpatient protocols relating to the most expensive fractures and longest hospital stays that we have identified can improve, this may lead to improved outcomes and a reduction in hospital charges for facial fractures.
authors.affiliation: Department of Restorative Dentistry and Biomaterial Sciences, Harvard School of Dental Medicine, Boston, MA, USA. romesh_nalliah@hsdm.harvard.edu
authors.forename: Romesh P
authors.initials: RP
authors.lastname: Nalliah
authors.forename: Veeratrishul
authors.initials: V
authors.lastname: Allareddy
authors.forename: Min Kyeong
authors.initials: MK
authors.lastname: Kim
authors.forename: Shankar R
authors.initials: SR
authors.lastname: Venugopalan
authors.forename: Praveenkumar
authors.initials: P
authors.lastname: Gajendrareddy
authors.forename: Veerasathpurush
authors.initials: V
authors.lastname: Allareddy
mesh_terms: D005151:Facial Injuries / Q000191:economics* / Q000209:etiology / Q000601:surgery; D005260:Female; D006760:Hospitalization / Q000191:economics* / Q000706:statistics & numerical data; D006801:Humans; D038801:International Classification of Diseases; D007902:Length of Stay / Q000191:economics* / Q000706:statistics & numerical data; D008297:Male; D012189:Retrospective Studies; D014481:United States; D016270:United States Agency for Healthcare Research and Quality