The Financial Burden of Hospitalization Associated With Odontogenic Infections
Former Chief Resident, Department of Oral and Maxillofacial Surgery, Virginia Commonwealth University School of Dentistry, Richmond, VAJournal of oral and maxillofacial surgery: official journal of the American Association of Oral and Maxillofacial Surgeons (Impact Factor: 1.43). 02/2013; 71(4). DOI: 10.1016/j.joms.2012.11.024
PURPOSE: Although it is generally agreed that there are high costs involved in the management of acute odontogenic infections in hospitalized patients, there are sparse data on the actual amounts involved. The purpose of this study was to examine the costs and charges associated with the treatment of such patients in a university medical center hospital. PATIENTS AND METHODS: Hospital records from 2003 through 2010 were reviewed for patients admitted for management of acute odontogenic infections, and 327 patients were identified. The cost of their hospital care, doctors' fees, and hospital charges (amount billed) were then determined. RESULTS: An average of 40 patients was seen each year. The cost of their care ranged from $1,035 to $252,888 (average, $9,417). This did not include doctors' charges. The hospital charges averaged $28,841 per patient. Over the 8-year period, the hospital costs exceeded $3.3 million and the charges submitted were in excess of $10 million. CONCLUSIONS: The management of acute odontogenic infections in the hospital engenders considerable costs. Although it would appear that the charges compensate for these costs, that figure does not represent the amount actually collected, which is much less based on the economic status of the patient population generally being treated. Methods to lower the costs associated with hospitalization are proposed.
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- "Acute odontogenic maxillofacial infections are frequently the outcome of untreated dental diseases (Bratton et al., 2002). Such infections remain prevalent in many countries and urgent treatment of them is necessary because of their potentially fatal complications (Wang et al., 2005) but their treatment in hospitals incurs substantial costs (Ahmad et al., 2013). However, some of these infections may be successfully treated in outpatient treatment facilities (Seppanen et al., 2010). "
ABSTRACT: Objectives: To examine the distribution of treatment facilities accepting patients with acute odontogenic maxillofacial infections (AOMIs), time trends in incidence and relate these infections with a number of determinants. Methods: A national Lithuanian retrospective study gathered data on all patients treated in outpatient/inpatient treatment facilities. Adjusted Incidence Ratios (AIRs) of AOMIs were calculated separately for each type of infection and for each year. Administrative districts (ADs) were grouped into low, medium, and high thirds based on the regional determinants: socio-economic index (R-SEI), access to basic (R-BDCI) or specialized dental care (R-SDCI) and index of systemic diseases (R-ISD). Results: There were no statistically significant geographical differences in the distribution of TFs providing care for patients with AOMIs. Numbers of treatment facilities consistently increased from 2009 to 2013, but there was no consistent increase/ decrease in the incidence of AOMIs (~1%). Regions with the highest R-SEI tended to have a higher incidence of AOMIs as compared to regions with medium or low R-SEI. When controlled for other determinants, lower R-BDCI∕R-SDCI scores were associated with a higher incidence of AOMIs. Conclusions: High annual incidences (~1% of a total population) were diagnosed and treated for AOMIs, but there was no consistent time trend for these infections.
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ABSTRACT: The purpose of this retrospective cohort study was to describe the demographics of patients with odontogenic infections and to evaluate the costs associated with the demographic, social, treatment, and hospital course variables in patients hospitalized for odontogenic infections. A retrospective chart review was conducted in patients admitted for odontogenic infections at Harborview Medical Center from July 1, 2001, through June 30, 2011. In total, 318 patient charts were reviewed and included. The unsponsored portion of the patient population increased from 14.7-61.9% over the course of the study. The average hospital bill per patient in this study was $17,053. Of the $5,422,854 billed, only $1,528,869 was received by the hospital in payment for services rendered, equating to $3,893,985 in lost potential revenue. The variables location of treatment, length of stay, length of stay in the intensive care unit, additional use of the operating room, and antibiotic regimen accounted for 90.2% of the variation in the hospital bill. Unsponsored patients constituting 61.9% of the patient population represent an enormous challenge for hospitals and providers. To maintain the standard of care for all patients and still be able to provide care to patients without insurance, county hospitals and academic institutions must seek to improve cost efficiency. The present findings reinforce the need to be vigilant about the decision to admit, take to the operating room, admit to an intensive care unit, and discharge to lower the costs to the patient, hospital, and society for the management of odontogenic infections.
Article: Oral health: Reverse referral[Show abstract] [Hide abstract]
ABSTRACT: The role of the BDJ is to inform its readers of ideas, opinions, developments and key issues in dentistry - clinical, practical and scientific - stimulating interest, debate and discussion amongst dentists of all disciplines.
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