title: Epidemiology and resource utilization in pediatric facial fractures.
abstract: BACKGROUND
  Pediatric facial fractures, although uncommon, have a significant impact on public health and the US economy by the coexistence of other injuries and developmental deformities. Violence is one of the most frequent mechanisms leading to facial fracture. Teaching hospitals, while educating future medical professionals, have been linked to greater resource utilization in differing scenarios. This study was designed to compare the differences in patient characteristics and outcomes between teaching and non-teaching hospitals for violence-related pediatric facial fractures.
  
  
  METHODS
  Using the 2000-2009 Kids' Inpatient Database, 3881 patients younger than 18 years were identified with facial fracture and external cause of injury code for assault, fight, or abuse. Patients admitted at teaching hospitals were compared to those admitted at non-teaching hospitals in terms of demographics, injuries, and outcomes.
  
  
  RESULTS
  Overall, 76.2% of patients had been treated at teaching hospitals. Compared to those treated at non-teaching hospitals, these patients were more likely to be younger, non-white, covered by Medicaid, from lower income zip codes, and have thoracic injuries; but mortality rate was not significantly different. After adjusting for potential confounders, teaching status of the hospital was not found as a predictor of either longer lengths of stay (LOS) or charges.
  
  
  CONCLUSIONS
  There is an insignificant difference between LOS and charges at teaching and non-teaching hospitals after controlling for patient demographics. This suggests that the longer LOS observed at teaching hospitals is related to these institutions being more often involved in the care of underserved populations and patients with more severe injuries.
authors.affiliation: Division of Plastic Surgery, Indiana University School of Medicine, Indianapolis, Indiana.
authors.forename: Tahereh
authors.initials: T
authors.lastname: Soleimani
authors.affiliation: Division of Plastic Surgery, Indiana University School of Medicine, Indianapolis, Indiana.
authors.forename: Shawn Travis
authors.initials: ST
authors.lastname: Greathouse
authors.affiliation: Division of Plastic Surgery, Indiana University School of Medicine, Indianapolis, Indiana.
authors.forename: Rajiv
authors.initials: R
authors.lastname: Sood
authors.affiliation: Division of Plastic Surgery, Indiana University School of Medicine, Indianapolis, Indiana.
authors.forename: Youssef H
authors.initials: YH
authors.lastname: Tahiri
authors.affiliation: Division of Plastic Surgery, Indiana University School of Medicine, Indianapolis, Indiana. Electronic address: stholpad@iupui.edu.
authors.forename: Sunil S
authors.initials: SS
authors.lastname: Tholpady
mesh_terms: D000293:Adolescent; D002648:Child; D002649:Child Abuse / Q000706:statistics & numerical data; D002675:Child, Preschool; D016208:Databases, Factual; D005260:Female; D017722:Hospital Charges / Q000706:statistics & numerical data*; D006784:Hospitals, Teaching / Q000191:economics / Q000706:statistics & numerical data*; D006801:Humans; D007223:Infant; D007902:Length of Stay / Q000191:economics / Q000706:statistics & numerical data*; D008297:Male; D008446:Maxillofacial Injuries / Q000191:economics / Q000453:epidemiology* / Q000209:etiology / Q000628:therapy; D012189:Retrospective Studies; D012887:Skull Fractures / Q000191:economics / Q000453:epidemiology* / Q000209:etiology / Q000628:therapy; D016896:Treatment Outcome; D014481:United States / Q000453:epidemiology; D014754:Violence / Q000706:statistics & numerical data*
keywords: Facial fractures; Mandibular fracture; Pediatric; Resource utilization; Teaching hospital; Violence