Neil Bhattacharyya

Harvard Medical School, Boston, Massachusetts, United States

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Publications (171)286.58 Total impact

  • Neil Bhattacharyya, Harrison W Lin
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    ABSTRACT: The Medicare provider utilization and payment public use datafile for 2012 was analyzed with respect to otolaryngology specialty providers to characterize otolaryngology services billed to and reimbursed by Medicare, both overall and according to provider characteristics. Among 8450 otolaryngology specialty providers submitting claims, the top 5 billed services were (count in millions): 99213 (2.23), 95165 (1.81), 99203 (0.92), 99214 (0.83), and 69210 (0.71), and the top 5 total reimbursed services were (aggregate total reimbursements in millions): 99213 ($114), 99203 ($68), 99214 ($63), 31231 ($60), and 31575 ($47). There was a mean of 1567 services billed per provider with an average (yearly) total reimbursement from Medicare of $76,068 per provider. These data characterize the current level of provision of otolaryngology services to the Medicare population.
    Otolaryngology--head and neck surgery : official journal of American Academy of Otolaryngology-Head and Neck Surgery. 08/2014;
  • Harrison W Lin, Neil Bhattacharyya
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    ABSTRACT: Quantify the relationships between dizziness, falls, and obesity among adults.
    The Laryngoscope 07/2014; · 1.98 Impact Factor
  • Sophie Shay, Nina L Shapiro, Neil Bhattacharyya
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    ABSTRACT: Investigate the incidence and characteristics of revisits following ambulatory pediatric tonsillectomy/adenotonsillectomy.
    The Laryngoscope 06/2014; · 1.98 Impact Factor
  • Neil Bhattacharyya
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    ABSTRACT: Objective: Determine the prevalence of voice problems and types of voice disorders among United States adults. Study design: Cross-sectional analysis of national health survey. Methods: The 2012 National Health Interview Survey was analyzed, identifying adult cases reporting a voice problem in the preceding 12 months. In addition to demographic data, specific data regarding visits to healthcare professionals for voice problems, diagnoses given and severity of the voice problem were analyzed. The relationship between voice problems and lost workdays was investigated. Results: An estimated 17.9±0.5 million adults (mean age 49.1 years; 62.9±1.2% female) reported a voice problem (7.6±0.2%). Overall, 10.0±0.1% saw a health care professional for their voice problem and 40.3±1.8% were given a diagnosis. Females were more likely than males to report a voice problem (9.3±0.3% versus 5.9±0.3%, p<0.001). 22% and 11% reported their voice problem to be a moderate or a big/very big problem, respectively. Infectious laryngitis was the most common diagnosis mentioned (685±86 thousand cases, 17.8±2.0%). Gastroesophageal reflux disease was mentioned in 308±54 thousand cases (8.0±1.4%). The mean number of days affected with the voice problem in the past year was 56.2±2.6 days. Respondents with a voice problem reported 7.4±0.9 lost workdays in the past year versus 3.4±0.1 lost workdays for those without (contrast, +4.0 lost workdays, p<0.001). Conclusion: Voice problems affect 1 in 13 adults, annually. A relative minority seek health care for their voice problem, even though the self-reported subjective impact of the voice problem is significant.
    The Laryngoscope 04/2014; · 1.98 Impact Factor
  • Neil Bhattacharyya
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    ABSTRACT: Objective: Determine rates and reasons for revisits after adult uvulopalatopharyngoplasty (UPPP). Study design: Cross-sectional analysis of multi-state ambulatory surgery and hospital databases. Methods: Ambulatory adult UPPP cases were extracted from the State Ambulatory Surgery Databases for New York, Florida, Iowa and California for 2010. Cases were linked to the State Emergency Department Databases and the State Inpatient Databases for visit encounters occurring 0 to 14 days after the procedure. The number of revisits (including readmissions) was determined as well as the diagnosis at the revisit. The overall mortality rate and intervention rate for post-procedural bleeding were determined. Results: 2,349 ambulatory UPPP cases were extracted (mean age, 44.9 years). Overall, 9.7% of patients had a revisit after surgery (13.7% revisited the ambulatory surgery center, 68.3% the emergency department and 18.1% to inpatient admission). The primary diagnoses at the first revisit were bleeding (38.3%), acute pain (21.2%) and fever/dehydration (6.6%). Overall, 1.6% of patients incurred a second revisit. Among all cases, 3.7% and 0.6% presented with a bleeding diagnosis at a first and second revisit, respectively. Among revisits, 11.5% and 26.3% underwent a procedure to control bleeding at the first and second revisits, respectively. One death occurred for an overall 14 day mortality rate of 0.043%. Conclusion: Ambulatory UPPP demonstrates an good postoperative safety profile. Postoperative hemorrhage and acute pain, as well as fever/dehydration, are common reasons for revisits. These particular complications should be targeted for prevention to reduce postoperative revisit rates.
    The Laryngoscope 04/2014; · 1.98 Impact Factor
  • Neil Bhattacharyya
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    ABSTRACT: Objective: Determine rates and reasons for revisits after adult ambulatory sinonasal surgery. Study design: Cross-sectional analysis of multi-state ambulatory surgery and hospital databases. Methods: Ambulatory adult sinonasal procedures were extracted from the State Ambulatory Surgery Databases for New York, Florida, Iowa and California for 2010. Cases were linked to the State Emergency Department Databases and the State Inpatient Databases for visit encounters occurring 0 to 14 days after the procedure. The number of revisits (including readmissions) was determined as well as the reason for revisit. The overall rate of and intervention rate for post-procedural bleeding were determined. Results: 35,678 ambulatory sinonasal cases were extracted (mean age, 47.5 years). Overall, 5.0% of patients had a revisit after surgery (18.9% revisited the ambulatory surgery center, 67.0% the emergency department and 14.1% to inpatient admission). The primary diagnoses at the first revisit were bleeding (23.0%), acute pain (3.7%) and fever/dehydration (3.8%). Overall, 0.8% of patients incurred a second revisit. Among all cases, 1.2% and 0.3% presented with a bleeding diagnosis at a first and second revisit, respectively. Among revisits, 1.0% and 17.9% underwent a procedure to control bleeding at the first and second revisits, respectively. Three deaths were noted for an overall 14 day mortality rate of 0.0084%. Conclusion: There is a non-negligible revisit rate after ambulatory sinonasal surgery. The most common reasons for revisit include bleeding, but also acute pain and fever/dehydration. These particular complications should be targeted for prevention to reduce postoperative revisit rates.
    The Laryngoscope 01/2014; · 1.98 Impact Factor
  • Neil Bhattacharyya, Lynn J Kepnes
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    ABSTRACT: Objective: Determine revisits and reasons for revisits after adult tonsillectomy. Study design: Cross-sectional analysis of multi-state ambulatory surgery and hospital databases. Methods: Ambulatory adult tonsillectomies performed as the sole procedure were extracted from the State Ambulatory Surgery Databases for New York, Florida, Iowa and California for 2010. Cases were linked to the State Emergency Department Databases and the State Inpatient Databases for visit encounters occurring 0 to 14 days after tonsillectomy. The number of revisits (including readmissions) was determined as well as the reason for revisit categorized as post-tonsillectomy bleeding, acute pain or fever/dehydration. The overall rate of occurrence of and intervention rate for post-tonsillectomy bleeding was determined. Results: 7,748 adult tonsillectomies were examined (mean age 29.2 years; 64.4% female). Overall, 11.6% of patients had a revisit after tonsillectomy (9.6% revisited the ambulatory surgery center, 78.8% the emergency department and 11.6% to inpatient admission). The primary diagnoses at the first revisit were bleeding (41.3%), acute pain (22.1%) and fever/dehydration (13.2%). Overall, 2.1% of patients incurred a second revisit after adult tonsillectomy (10.7% of these to inpatient admission). Among all tonsillectomies, 4.8% of adult tonsillectomies presented with a bleeding diagnosis at a first revisit. Overall, 2.2% underwent a procedure to control bleeding at a first revisit. Conclusion: The current data quantify at a multi-state-level revisits, revisit diagnoses and procedural rates for post-tonsillectomy bleeding in the adult population. Interventions to offset revisits for acute pain and fever/dehydration should be explored to decrease adult tonsillectomy morbidity.
    The Laryngoscope 11/2013; · 1.98 Impact Factor
  • Neil Bhattacharyya, Lynn J Kepnes
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    ABSTRACT: Nasal polyps occur in a significant fraction of patients with chronic rhinosinusitis. However, patterns of medical management in nasal polyp cases are unknown. We sought to determine actual national estimates and contemporary prescribing patterns for ambulatory care visits with a diagnosis of nasal polyposis (NP). The National Ambulatory Medical Care Survey and the National Hospital Ambulatory Medical Care Survey 2004-2010 were accessed, extracting all adult office visits with a diagnosis of NP. Demographic, provider type, and medication classes prescribed were determined. National estimates for the number of ambulatory medical care visits along with medications prescribed by provider type (otolaryngologist versus nonotolaryngologist) were determined. There were an estimated 442,024 ± 49,609 adult office visits annually with an NP diagnosis (54.8% men; mean age, 52.3 years); 64.6% of these visits were with otolaryngologists. Medication prescribing rates with a diagnosis of NP were nasal steroids (43.7%), oral steroids (26.9%), antibiotics (26.0%), and oral antihistamines (18.5%). Medication use rates for nasal steroids, oral steroids, oral antihistamines, and antibiotics were 36.3, 25.9, 15.3, and 22.2% for otolaryngology visits, respectively. Analogous medication use rates were 57.1, 28.8, 24.2, and 32.9% of nonotolaryngology visits, respectively. These differences by provider were not statistically significant (all, p ≥ 0.113). Although nasal steroids are efficacious in NP, they are likely underprescribed. Oral steroids are also commonly prescribed for NP and should be considered a standard option in the treatment of NP.
    American Journal of Rhinology and Allergy 11/2013; 27(6):479-81.
  • Douglas Sidell, Nina L Shapiro, Neil Bhattacharyya
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    ABSTRACT: To determine if obesity is a significant risk factor for acute otitis media (AOM), allergic rhinitis (AR), or chronic rhinosinusitis (CRS) in children and to understand the potential otolaryngological implications of childhood obesity. Cross-Sectional Analysis. The 2006 and 2008 the Medical Expenditure Panel Survey was utilized to identify school-aged children with AOM, AR, and/or CRS. Risk factors for the diagnoses extracted included standard demographics and the presence or absence of obesity. Multivariate analyses were conducted for associations between childhood obesity and AOM, AR, and CRS. 42.1 million (95% CI, 40.4-44.2) school-age children (unweighted N = 10623) were sampled in 2006 and 2008. There was a slight male predominance (51.0% [95% CI, 49.8-52.2]). Of these patients, 2.2 million (95% CI 1.9-2.4) received a diagnosis of AOM, 4.0 million (95% CI 3.6-4.4) received a diagnosis of AR, and 1.7 million (95% CI 1.4-1.9) received a diagnosis of CRS. Approximately 9.3 million (95% CI 8.7-10.0) children were obese, representing 22.2% (95% CI 21.0-23.3) of the U.S. population (age 6-17). Utilizing an adjusted multivariate model, childhood obesity was found to be associated with AOM (odds ratio, 1.44; [95% CI 1.08-1.93]; P = 0.033). Significant associations between obesity and AR (OR 1.14; [95% CI 0.88-1.47]; P = 0.60) or obesity and CRS (OR0.73; [95% CI 0.48-1.10]; P = 0.79) were not identified. Childhood obesity appears to be associated with the development of AOM; however, an association between obesity and AR or CRS was not demonstrated. Given that in the United States nearly one-fourth of all children seeking health care are obese, these data may have important preventative care implications. 2C. Laryngoscope, 2013.
    The Laryngoscope 08/2013; · 1.98 Impact Factor
  • Daniel S Roberts, Harrison W Lin, Neil Bhattacharyya
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    ABSTRACT: OBJECTIVES/HYPOTHESIS: Characterize health care practice patterns for balance disorders in the elderly. STUDY DESIGN: Cross-sectional analysis of national health care survey. METHODS: Balance disorder cases in patients aged ≥65 years were extracted from the 2008 National Health Interview Survey. Records were analyzed for health professionals seen, diagnostic testing ordered, diagnoses given, and treatments offered. Relationships between diagnostic success, imaging studies, and specialty providers seen were compared. RESULTS: Among 7.02 ± 0.22 million elderly persons reporting a balance problem, 50.0% (3.44 ± 0.16 million) saw a health professional, and 35.8% saw ≥3 providers; 59.6% of elderly patients reported a diagnosed cause for the balance problem. The most common causes were medication side effects (11.3%), inner ear infection (11.0%), heart disease (8.6%), and loose ear crystals (7.9%). Imaging studies had been obtained in 56.7% (2.00 ± 0.11 million cases). Among 24.3% of patients receiving some form of treatment, 61.7% had been taking prescription medication, most commonly diuretic agents (36.5%), anxiolytic agents (25.1%), and meclizine (21.4%). Seeing an otolaryngologist or neurologist was associated with a higher but similar rate of diagnostic imaging studies (70.1%, P = .029 and 78.5%, P < .001). However, obtaining an imaging study was not associated with a diagnosed cause of the balance disorder (61.5% with imaging vs. 56.9% without, P = .265). CONCLUSIONS: Despite a high prevalence of balance problems in the elderly, a significant proportion do not come to a clear diagnosis. There is a noteworthy rate of prescription medication utilization in this population. Given an increasingly aging population, attention needs to be given to balance problems in the elderly to optimize diagnosis and health care utilization. LEVEL OF EVIDENCE: 2b Laryngoscope, 2013.
    The Laryngoscope 05/2013; · 1.98 Impact Factor
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    ABSTRACT: OBJECTIVES/HYPOTHESIS: To review the presentation and management of malignant tumors of the mandible in children. STUDY DESIGN: Case series. METHODS: Children 0 to 21 years old presenting to a tertiary pediatric hospital with a diagnosis of a malignant tumor involving the mandible were included. Comparison groups included children from the Surveillance, Epidemiology, and End Results database with malignant mandible tumors as well as a group of children with benign mandibular lesions from the same institution. Main outcome measures for the institutional malignant group included presentation, tumor characteristics, treatment modalities, and clinical outcome. RESULTS: Sixteen patients with malignant and 183 patients with benign lesions were identified at the primary institution. The most common presentation in both groups was mandibular swelling or mass. Malignant tumors included sarcoma (n = 11), leukemia/lymphoma (n = 2), squamous cell carcinoma (n = 1), malignant spindle cell tumor (n = 1), and yolk sac tumor (n = 1). The national database identified 56 malignant cases, of which 71% were sarcomas. Thirteen patients at our institution (81%) underwent mandibulectomy and 12 were reconstructed using free tissue transfer. Eleven of the 13 (85%) were treated with adjuvant therapy. After an average follow-up of 32.8 months, seven (44%) had no evidence of disease, three (19%) were deceased, three (19%) were alive with disease, and three (19%) were lost to follow-up. CONCLUSIONS: Malignant mandibular tumors in children are most often sarcomas but can include other rare lesions. Free flap reconstruction is a reasonable option for even very young children requiring extensive mandibular surgery. LEVEL OF EVIDENCE: 4.Laryngoscope, 2013.
    The Laryngoscope 05/2013; · 1.98 Impact Factor
  • Sameer Ahmed, Nina L Shapiro, Neil Bhattacharyya
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    ABSTRACT: OBJECTIVES/HYPOTHESIS: Determine the incremental health care costs associated with the diagnosis and treatment of acute otitis media (AOM) in children. STUDY DESIGN: Cross-sectional analysis of a national health-care cost database. METHODS: Pediatric patients (age < 18 years) were examined from the 2009 Medical Expenditure Panel Survey. From the linked medical conditions file, cases with a diagnosis of AOM were extracted, along with comorbid conditions. Ambulatory visit rates, prescription refills, and ambulatory health care costs were then compared between children with and without a diagnosis of AOM, adjusting for age, sex, region, race, ethnicity, insurance coverage, and Charlson comorbidity Index. RESULTS: A total of 8.7 ± 0.4 million children were diagnosed with AOM (10.7 ± 0.4% annually, mean age 5.3 years, 51.3% male) among 81.5 ± 2.3 million children sampled (mean age 8.9 years, 51.3% male). Children with AOM manifested an additional +2.0 office visits, +0.2 emergency department visits, and +1.6 prescription fills (all P <0.001) per year versus those without AOM, adjusting for demographics and medical comorbidities. Similarly, AOM was associated with an incremental increase in outpatient health care costs of $314 per child annually (P <0.001) and an increase of $17 in patient medication costs (P <0.001), but was not associated with an increase in total prescription expenses ($13, P = 0.766). CONCLUSIONS: The diagnosis of AOM confers a significant incremental health-care utilization burden on both patients and the health care system. With its high prevalence across the United States, pediatric AOM accounts for approximately $2.88 billion in added health care expense and is a significant health-care utilization concern. LEVEL OF EVIDENCE: 2C.
    The Laryngoscope 05/2013; · 1.98 Impact Factor
  • Kyle J Chambers, Neil Bhattacharyya
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    ABSTRACT: OBJECTIVES/HYPOTHESIS: To determine trends in office visits and medical specialty seen for surgical diagnoses of the thyroid gland. STUDY DESIGN: A cross-sectional analysis of a national healthcare database. METHODS: From the National Ambulatory Medical Care Survey (NAMCS), all cases of surgical thyroid disorders (e.g., benign neoplasm of thyroid gland, malignant neoplasm of thyroid gland, multinodular goiter) were extracted for 2 calendar year cohorts: 1995 to 1999 and 2005 to 2009. In addition to demographic information, the medical specialty of the health care provider seen was extracted. Comparisons were conducted for the proportion of surgical thyroid cases seen between general surgeons and otolaryngologists for the respective cohorts. RESULTS: In the 1995 to 1999 cohort, there were a total of 107 ± 13 thousand outpatient visits annually to either general surgery or otolaryngology for surgical thyroid conditions. Among these, 62.7 ± 8.4 thousand visits (58.3 ± 5.6%) were seen by general surgery versus 44.8 ± 9.1 thousand (41.7 ± 5.6%) seen by otolaryngology. In comparison, in the 2005 to 2009 cohort, there were 218 ± 29 thousand visits annually for surgical thyroid conditions. Among these, 88.4 ± 17 thousand (40.5 ± 5.4%) were seen by general surgery versus 130 ± 21 thousand (59.5 ± 5.4%) seen by otolaryngology. The increase in proportion of surgical thyroid patients seen by otolaryngology in the second 5 year cohort was statistically significant (P = 0.032, chi-square). CONCLUSIONS: There is a national trend in the United States toward otolaryngologists seeing an increasing majority proportion of increasingly prevalent surgical thyroid conditions. These data objectively confirm the perceived increasing role of otolaryngologists in the management of surgical thyroid disorders on a national level. LEVEL OF EVIDENCE: 2a. Laryngoscope, 2013.
    The Laryngoscope 04/2013; · 1.98 Impact Factor
  • Neil Bhattacharyya
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    ABSTRACT: OBJECTIVES/HYPOTHESIS: Determine temporal trends in otolaryngologists' utilization of computed tomography (CT) in the diagnosis of sinonasal disorders. STUDY DESIGN: Cross-sectional analysis of national health-care database. METHODS: The National Ambulatory Medical Care Survey was examined from 2005 to 2010, and all visits to otolaryngologists with a chronic sinonasal diagnosis code (e.g., chronic sinusitis, chronic rhinitis, allergic rhinitis, and septal deviation) were extracted. The demographics and proportion of otolaryngology visits at which a CT scan was ordered were determined for each calendar year, and trends were determined for the 6-year period. RESULTS: An estimated 31.1±2.8 million otolaryngology visits with sinonasal diagnoses were extracted (unweighted N=2,099). The average patient age was 43.2±0.6 years, with a female predominance (57.1%±1.8%). The most common diagnoses were chronic rhinosinusitis (10.9 million visits, unweighted N=819) and allergic rhinitis (10.7 million visits, unweighted N=639). Overall, 10.4%±2.2% of sinonasal diagnosis visits involved CT (unweighted N=232), ranging from 8.4%±3.0% in 2007 to 12.3%±2.6% in 2008; in 2010, 11.7%±2.9% of visits included CT. There was no statistically significant difference in CT rates over the course of these 6 calendar years (P=.798). CONCLUSIONS: Despite widespread availability of imaging and a strong prevalence of sinonasal diagnoses, otolaryngologists' CT ordering patterns have not resulted in increased utilization over the past 6 years. This suggests that otolaryngologists are remaining consistent in their ordering patterns for sinonasal CT. LEVEL OF EVIDENCE: 2c. Laryngoscope, 2013.
    The Laryngoscope 02/2013; · 1.98 Impact Factor
  • Neil Bhattacharyya, Lynn J Kepnes
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    ABSTRACT: OBJECTIVES/HYPOTHESIS: Determine if patterns of care for acute sinusitis have changed after the publication of the adult sinusitis clinical practice guideline. STUDY DESIGN: Cross-sectional study with historical controls. METHODS: Cases of adult acute sinusitis occurring in 2005-2006 (before guideline publication) and 2009-2010 (>1 year after guideline publication) were extracted from the National Ambulatory Medical Care Survey and the National Hospital Ambulatory Care Survey. Changes in the rates of analgesic recommendations, oral antibiotic prescriptions, and choice of antibiotic therapy were determined and compared before and after guideline publication and relative to guideline recommendations. RESULTS: An estimated 18.1±1.8 million cases of adult acute sinusitis were studied before (7.9±0.9 million visits for 2005-2006) and after (10.2±1.5 million visits for 2009-2010) guideline publication. Recommendation rates for analgesics did not change significantly (18.9% before vs. 23.0% after, P=.470). The proportion of patients receiving oral antibiotics increased after guideline publication (75.5% before vs. 85.7% after, P=.021). In keeping with guideline recommendations, the proportion of patients treated with amoxicillin as the agent of choice when antibiotics are prescribed increased from 8.1% to 29.4% after guideline publication (P=.001). CONCLUSIONS: Care patterns for the medical treatment of acute adult sinusitis have changed after guideline publication, with an increase in oral antibiotic prescription rates in cases of acute sinusitis and increase in the use of amoxicillin as the first-line antimicrobial agent. The latter is strongly in keeping with guideline recommendation. Clinicians' espousal of the analgesic recommendations likely needs improvement to better comply with guideline recommendations. LEVEL OF EVIDENCE: 2b. Laryngoscope, 2013.
    The Laryngoscope 02/2013; · 1.98 Impact Factor
  • Neil Bhattacharyya
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    ABSTRACT: OBJECTIVES/HYPOTHESIS: Determine whether adult obesity is associated with chronic rhinosinusitis (CRS) and/or allergic rhinitis (AR). STUDY DESIGN: Cross-sectional analysis of medical panel survey. METHODS: The Medical Expenditure Panel Survey, a large-scale household-based survey of health care utilization in the United States (2008 and 2010) was examined, identifying adult cases of CRS and AR. The presence or absence of obesity (body mass index ≥ 30 kg/m(2) ) was determined. Adjusting for age, sex, race, geographic region, insurance coverage, and Charlson Comorbidity Index, odds ratios for the presence of CRS and/or AR in the presence of obesity were determined. The relations between body mass index as a linear variable and the presence of CRS and AR were determined. RESULTS: A total of 17.6 ± 0.6 million adults reported AR (7.7% ± 0.3%) and 13.0 ± 0.5 million reported CRS (5.7% ± 0.2%; weighted estimates). Additionally, 64.9 ± 1.4 million adults (29.0% ± 0.4%) were classified as obese based on body mass index. The adjusted odds ratio for AR when obesity was present was 1.22 (P < .001, 95% confidence interval = 1.12-1.33). The adjusted odds ratio for CRS when obesity was present was 1.31 (P < .001, 95% confidence interval = 1.18-1.45). Increasing body mass index as a continuous variable was significantly associated with the presence of both AR (odds ratio = 1.023, P < .001) and CRS (odds ratio = 1.022, P < .001). CONCLUSIONS: The current data demonstrate an increased prevalence of adult obesity associated with both AR and CRS. LEVEL OF EVIDENCE: 2b.
    The Laryngoscope 02/2013; · 1.98 Impact Factor
  • Josef Shargorodsky, Neil Bhattacharyya
    The Laryngoscope 01/2013; 123(1):4-6. · 1.98 Impact Factor
  • Source
    David Jung, Neil Bhattacharyya
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    ABSTRACT: We evaluated the association of hearing loss with employment and income in adults. Patients with a coded diagnosis of hearing loss were identified from the 2006 and 2008 Medical Expenditure Panel Survey linked household and medical conditions files and compared to patients without hearing loss. Differences in employment, wage income, and Supplemental Security Income were evaluated with multivariate regression models after adjustment for several demographic and Charlson comorbidity variables. An estimated 933,921 +/- 88,474 adults were identified with hearing loss (54.7% of whom were male; mean age for all, 51.0 years). Patients with hearing loss were more likely to be unemployed or partly unemployed than those without hearing loss (adjusted odds ratio, 2.2; p < 0.001). Similarly, adults with hearing loss were less likely to have any wage income than those without hearing loss (adjusted odds ratio, 2.5; p < 0.001). The population with hearing loss earned a mean wage of $23,481 +/- $3,366, versus $31,272 +/- $517 for the population without hearing loss (difference in wages, $7,791; p < 0.001). The association between hearing loss and receiving Supplemental Security Income was not significant (p = 0.109). Adults with hearing loss are more likely to be unemployed and on average earn significantly less wage income than adults without hearing loss. Further work is needed to determine the potential impact of treatment on these differences.
    The Annals of otology, rhinology, and laryngology 12/2012; 121(12):771-5. · 1.21 Impact Factor
  • Neil Bhattacharyya, Lynn J Kepnes
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    ABSTRACT: Objective(1) Understand the epidemiology of obstructive sleep apnea (OSA) ambulatory office visits in the United States. (2) Quantify the prevalence of comorbid illnesses that are likely to occur in the setting of OSA.Methods From the 2008-2009 National Ambulatory Medical Care Surveys and National Hospital Ambulatory Medical Care Surveys, adult cases with a diagnosis of OSA were extracted. The epidemiology of OSA was determined. The prevalences of comorbid priority illnesses (obesity, asthma, cerebrovascular disease, depression, hypertension, and ischemic heart disease) were also determined.Study DesignCross-sectional analysis of a national survey database.SettingAmbulatory care settings in the United States.ResultsThere were an estimated 4.1 ± 1.2 million annual visits with a diagnosis of OSA (60% ± 3.2% men; mean age, 56.4 ± 0.9 years). There were 419,000 ± 28,000 visits annually to otolaryngologists for OSA. Comorbid illnesses were obesity (23.8% ± 5.2%), asthma (14.3% ± 3.0%), cerebrovascular disease (2.5% ± 1.5%), depression (23.2% ± 2.6%), hypertension 53.8% ± 3.9%), and ischemic heart disease (10.3% ± 3.0%). Adjusting for age, sex, ethnicity, obesity, and race, statistically significant increased odds for the presence of obesity (3.6, P < .001), asthma (2.7, P < .001), depression (2.5, P < .001), and hypertension (2.0, P < .001) with OSA were noted. Increased odds for cerebrovascular disease and ischemic heart disease were not identified (P = .725 and P = .083, respectively).Conclusion Obstructive sleep apnea is a relatively common diagnosis in ambulatory and otolaryngologic care. It is associated with a significantly increased prevalence of several key priority health care conditions in the United States. Otolaryngologists and health care providers should be aware of these associations, understanding the potentially broad impact of OSA on general health.
    Otolaryngology Head and Neck Surgery 09/2012; · 1.73 Impact Factor
  • Neil Bhattacharyya
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    ABSTRACT: Objective To determine characteristics and trends for outpatient otolaryngology visits and practices in the United States.Study DesignCross-sectional analysis of national survey database.SettingAmbulatory care settings in the United States.Methods Outpatient otolaryngology records from 2005 to 2009 were extracted from the National Ambulatory Medical Care Survey. Visit characteristics were assessed for patient type (established versus new), expected source of payment, and average time spent with the physician. Provider characteristic variables were assessed for practice type (solo versus group), employment status of the physician, electronic claims submission, and the use of electronic medical records in the practice. Trends were analyzed for the above and the average number of outpatient visits per otolaryngologist per year.ResultsA total of 98.8 ± 7.0 million outpatient otolaryngology office visits, consisting of 27.9 ± 2.1 million new patient visits and 70.9 ± 5.3 million established patient visits, were studied. Expected sources of payment consisted of private insurance (65.1%), Medicare (21.1%), Medicaid (9.2%), and self-pay (2.0%). These sources did not change over the 5 calendar years (P = .301). Practitioners consisted of solo (30.7%) and group (69.3%) practices. Electronic medical records were in use in 40.2%. Electronic medical record penetration did significantly increase over the 5 years to 57.7% in 2009 (P = .002). The number of outpatient visits per otolaryngologist per year remained remarkably consistent over the years at about a mean of 3325 ± 299 visits seen per year (P = .580).Conclusion Characteristics of otolaryngology outpatient visits have remained largely consistent over the past 5 years. Electronic medical record penetration has noticeably increased. These results help validate prior Academy socioeconomic surveys.
    Otolaryngology Head and Neck Surgery 08/2012; · 1.73 Impact Factor

Publication Stats

2k Citations
286.58 Total Impact Points

Institutions

  • 1997–2014
    • Harvard Medical School
      • Department of Otology and Laryngology
      Boston, Massachusetts, United States
  • 2003–2013
    • University of California, Los Angeles
      • Department of Head and Neck Surgery
      Los Angeles, CA, United States
  • 1999–2013
    • Brigham and Women's Hospital
      • • Department of Medicine
      • • Division of Otolaryngology
      Boston, MA, United States
  • 1997–2012
    • Massachusetts Eye and Ear Infirmary
      • Department of Otolaryngology
      Boston, MA, United States
  • 2009
    • Dana-Farber Cancer Institute
      Boston, Massachusetts, United States
    • University of Colorado Hospital
      Denver, Colorado, United States
  • 2008–2009
    • Georgetown University
      • Department of Medicine
      Washington, D. C., DC, United States
  • 2007
    • Stanford Medicine
      Stanford, California, United States
  • 2006
    • Boston Children's Hospital
      Boston, Massachusetts, United States
  • 2004
    • Massachusetts Medical Society
      United States