title: Direct health care costs of laryngeal diseases and disorders.
abstract: OBJECTIVE
  To estimate the annual direct costs associated with the diagnosis and management of laryngeal disorders.
  
  
  METHODS
  Retrospective analysis of data from a large, nationally representative, administrative US claims database.
  
  
  METHODS
  Patients with a laryngeal disorder based on International Classification of Diseases,Ninth Revision-Clinical Modification codes from January 1, 2004 to December 31, 2008 and who were continuously enrolled for 12 months were included. Data regarding age, gender, geographic location, and type of physician providing the diagnosis were collected. Medical encounter, medication, and procedure costs were determined. Total and mean costs per person for 12 months were determined.
  
  
  RESULTS
  Of almost 55 million individuals in the database, 309,300 patients with 12 months follow-up, mean age of 47.3 years (standard deviation: 21.3), and 63.5% female were identified. Acute and chronic laryngitis, nonspecific causes of dysphonia, and benign vocal fold lesions were the most common etiologies. The total annual direct costs ranged between $178,524,552 to $294,827,671, with mean costs per person between $577.18 and $953.21. Pharmacy claims accounted for 20.1% to 33.3%, procedure claims 50.4% to 69.9%, and medical encounter claims 16.3% to 8.6% of overall direct costs. Antireflux medication accounted for roughly 10% and antibiotics 6% of annual direct costs.
  
  
  CONCLUSIONS
  This study establishes the economic impact of the assessment and management of patients with laryngeal disorders and permits cost comparisons with other diseases.
authors.affiliation: Duke Voice Care Center, Division of Otolaryngology-Head and Neck Surgery, Duke University Medical Center, Durham, North Carolina, USA. seth.cohen@duke.edu
authors.forename: Seth M
authors.initials: SM
authors.lastname: Cohen
authors.forename: Jaewhan
authors.initials: J
authors.lastname: Kim
authors.forename: Nelson
authors.initials: N
authors.lastname: Roy
authors.forename: Carl
authors.initials: C
authors.lastname: Asche
authors.forename: Mark
authors.initials: M
authors.lastname: Courey
mesh_terms: D005260:Female; D017048:Health Care Costs; D006801:Humans; D007818:Laryngeal Diseases / Q000175:diagnosis / Q000191:economics* / Q000628:therapy; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies