title: Hospital cost of pediatric patients with complicated acute sinusitis.
abstract: OBJECTIVE
  Review costs for pediatric patients with complicated acute sinusitis.
  
  
  METHODS
  A retrospective case series of patients in a pediatric hospital was created to determine hospital costs using a standardized activity-based accounting system for inpatient treatment between November 2010 and December 2014. Children less than 18 years of age who were admitted for complicated acute sinusitis were included in the study. Demographics, length of stay, type of complication and cost of care were determined for these patients.
  
  
  RESULTS
  The study included 64 patients with a mean age of 10 years. Orbital cellulitis (orbital/preseptal/postseptal cellulitis) accounted for 32.8% of patients, intracranial complications (epidural/subdural abscess, cavernous sinus thrombosis) for 29.7%, orbital abscesses (subperiosteal/intraorbital abscesses) for 25.0%, potts puffy tumor for 7.8%, and other (including facial abscess and dacryocystitis) for 4.7%. The average length of stay was 5.7 days. The mean cost per patient was $20,748. Inpatient floor costs (31%) and operating room costs (18%) were the two greatest expenditures. The major drivers in variation of cost between types of complications included pediatric intensive care unit stays and pharmacy costs.
  
  
  CONCLUSIONS
  Although complicated acute sinusitis in the pediatric population is rare, this study demonstrates a significant financial impact on the health care system. Identifying ways to reduce unnecessary costs for these visits would improve the value of care for these patients.
authors.affiliation: Division of Otolaryngology-Head and Neck Surgery, University of Utah School of Medicine, Salt Lake City, UT, United States.
authors.forename: Reema
authors.initials: R
authors.lastname: Padia
authors.affiliation: Division of Otolaryngology-Head and Neck Surgery, University of Utah School of Medicine, Salt Lake City, UT, United States.
authors.forename: Andrew
authors.initials: A
authors.lastname: Thomas
authors.affiliation: Division of Otolaryngology-Head and Neck Surgery, University of Utah School of Medicine, Salt Lake City, UT, United States.
authors.forename: Jeremiah
authors.initials: J
authors.lastname: Alt
authors.affiliation: Intermountain Healthcare, Surgical Services Clinical Program, Murray, UT, United States.
authors.forename: Craig
authors.initials: C
authors.lastname: Gale
authors.affiliation: Division of Otolaryngology-Head and Neck Surgery, University of Utah School of Medicine, Salt Lake City, UT, United States. Electronic address: jeremy.meier@imail.org.
authors.forename: Jeremy D
authors.initials: JD
authors.lastname: Meier
mesh_terms: D000208:Acute Disease; D000293:Adolescent; D001922:Brain Abscess / Q000191:economics* / Q000209:etiology; D020226:Cavernous Sinus Thrombosis / Q000191:economics / Q000209:etiology; D002648:Child; D002675:Child, Preschool; D016527:Drug Costs; D020802:Epidural Abscess / Q000191:economics* / Q000209:etiology; D017721:Hospital Costs; D006776:Hospitals, Pediatric / Q000191:economics*; D006801:Humans; D015278:Intensive Care Units, Pediatric / Q000191:economics; D007902:Length of Stay / Q000191:economics; D009873:Operating Rooms / Q000191:economics; D054517:Orbital Cellulitis / Q000191:economics* / Q000209:etiology; D010362:Patients' Rooms / Q000191:economics; D059369:Pott Puffy Tumor / Q000191:economics / Q000209:etiology; D012189:Retrospective Studies; D012852:Sinusitis / Q000150:complications / Q000191:economics*
keywords: Acute sinusitis; Complication; Cost; Pediatric