Resource utilization in primary repair of cleft palate.
OBJECTIVE
To estimate the current incidence of cleft palate in the United States and to determine national variations in resource utilization for primary repair of cleft palate.


METHODS
Retrospective analysis of a national, pediatric database (2009 Kids Inpatient Database).


METHODS
Patients aged 3 and below admitted for cleft palate repair were selected, using ICD-9 codes for cleft palate and procedure code for primary (initial) repair of cleft palate. A number of demographic variables were analyzed, and hospital charges were considered as a measure of resource utilization.


RESULTS
Primary repair of cleft palate was performed on 1,943 patients. The estimated incidence was 0.11% with male to female ratio of 1.2:1. Regional incidence ranged from 0.09% (Northeast) to 0.12% (Midwest). The mean age at surgery was 13.4 months. The average length of stay was 1.9 days. The average total charge nationwide was $22,982, ranging from $17,972 (South) to $25,671 (Northeast). Average charge in a teaching institution was $4,925 higher than for nonteaching institutions. The strongest predictor of charge was length of stay, increasing charge by $7,663 for every additional hospital day (P < 0.01).


CONCLUSIONS
National variations exist in resource utilization for primary repair of cleft palate, with higher charges in Northeastern states and teaching hospitals. The strongest predictor of increased resource use was length of stay, which was significantly higher at teaching institutions.
Department of Otolaryngology-Head and Neck Surgery, University of Minnesota, Minneapolis, Minnesota 55455, USA. owusuja@gmail.com
James A
JA
Owusu
Meixia
M
Liu
James D
JD
Sidman
Andrew R
AR
Scott
D002675:Child, Preschool; D002972:Cleft Palate / Q000191:economics* / Q000453:epidemiology / Q000601:surgery*; D003365:Costs and Cost Analysis; D005260:Female; D017722:Hospital Charges; D006784:Hospitals, Teaching / Q000191:economics; D006801:Humans; D015994:Incidence; D007223:Infant; D007902:Length of Stay / Q000191:economics; D008297:Male; D012189:Retrospective Studies; D014481:United States / Q000453:epidemiology