title: Factors influencing the health care expenditures of patients with laryngeal disorders.
abstract: OBJECTIVE
  To identify factors related to the health care spending of patients with 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. Age, sex, comorbidity, geography, provider type, visit type, and type of laryngeal pathology were collected. To identify which factors were related to the direct costs, a generalized linear regression with gamma distribution was used.
  
  
  RESULTS
  Of almost 55 million individuals in the database, 309,300 patients with a laryngeal disorder and 12 months of follow-up data were identified (mean [SD] age, 47.3 [21.3] years; 63.5% female). Age, sex, geographic region, number of comorbid conditions, type of provider, visit type, and laryngeal pathology were significantly associated with the health care expenditures (all P values <.05). Costs increased with increasing age and were greater for male patients, higher in the South and Northeast compared with the West and North-central regions, greater in 2008 compared with 2004, higher for inpatient compared with outpatient care, higher with increasing number of comorbid conditions, and lower if a patient was treated by a primary care physician only. Among the various laryngeal pathologies, the greatest direct costs were for laryngeal cancer and patients with multiple diagnoses.
  
  
  CONCLUSIONS
  This study identified multiple factors associated with the health care expenditures of patients with laryngeal disorders.
authors: Duke Voice Care Center, Division of Otolaryngology-Head & Neck Surgery, Duke University Medical Center, Durham, North Carolina, USA.
authors: Seth M
authors: SM
authors: Cohen
authors: Jaewhan
authors: J
authors: Kim
authors: Nelson
authors: N
authors: Roy
authors: Carl
authors: C
authors: Asche
authors: Mark
authors: M
authors: Courey
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D002648:Child; D002675:Child, Preschool; D016208:Databases, Factual / Q000706:statistics & numerical data; D005260:Female; D005102:Health Expenditures / Q000706:statistics & numerical data*; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D007345:Insurance Claim Review / Q000706:statistics & numerical data; D038801:International Classification of Diseases; D007818:Laryngeal Diseases / Q000145:classification / Q000191:economics* / Q000628:therapy; D008297:Male; D016345:Medicare Part B / Q000706:statistics & numerical data; D008875:Middle Aged; D012189:Retrospective Studies; D014481:United States; D055815:Young Adult