ORIGINAL ARTICLE
The impact of endoscopic sinus surgery on total direct healthcare costs among patients with chronic rhinosinusitis Patricia L. Purcell, MD1 , Sara Beck, MS2 and Greg E. Davis, MD, MPH1
Background: This study investigates how endoscopic sinus surgery (ESS) impacts total direct healthcare costs, medication usage, and frequency of imaging among patients with chronic rhinosinusitis (CRS). R Methods: Data were obtained from the MarketScan Commercial Claims and Encounters databases (Truven Health Analytics); patients who underwent ESS for CRS in 2008 were identified. Healthcare costs, days of antibiotic and oral steroid usage, and number of computed tomography (CT) and magnetic resonance imaging (MRI) studies were collected for 12 months prior to and 36 months aer surgery and compared in 1-year intervals.
Results: A total of 8963 surgical patients were included. Median total direct costs fell from $4750 at preoperative baseline (95% confidence interval [CI], $4661 to $4838) to $4212 by year 3 aer surgery (95% CI, $4078 to $4346). Disease-specific costs related to conditions commonly associated with CRS—asthma, allergy, depression, and headache–all decreased in the years aer surgery; the reduction was significant for all conditions but asthma. Mean days of antibiotic usage per year decreased from 28.2
C
hronic rhinosinusitis (CRS) is a common disease with a large impact on the U.S. healthcare system. It is one of the top 20 diagnoses treated in ambulatory care, generating an estimated 11 million office visits per year.1 Management of CRS is estimated to cost the United States about $8.6 billion per year2 ; compared to national averages for all
1 Department
of Otolaryngology–Head and Neck Surgery, University of Washington, Seattle, WA; 2 Department of Surgery, University of Washington, Seattle, WA
Correspondence to: Patricia L. Purcell, MD, 1959 NE Pacific Street, Box 356515, Seattle, WA 98195; e-mail: [email protected] Funding sources for the study: NIH (National Institute on Deafness and Other Communication Disorders [NIDCD], Institutional National Research Service Award for Research Training in Otolaryngology (PLP), 2T32DC000018). Potential conflict of interest: None provided. View this article online at wileyonlinelibrary.com. Received: 11 August 2014; Revised: 17 November 2014; Accepted: 2 December 2014 DOI: 10.1002/alr.21482 View this article online at wileyonlinelibrary.com.
days before surgery to 15.9 days by year 3 aer surgery, p value
The impact of endoscopic sinus surgery on total direct healthcare costs among patients with chronic rhinosinusitis Patricia L. Purcell, MD1 , Sara Beck, MS2 and Greg E. Davis, MD, MPH1
Background: This study investigates how endoscopic sinus surgery (ESS) impacts total direct healthcare costs, medication usage, and frequency of imaging among patients with chronic rhinosinusitis (CRS). R Methods: Data were obtained from the MarketScan Commercial Claims and Encounters databases (Truven Health Analytics); patients who underwent ESS for CRS in 2008 were identified. Healthcare costs, days of antibiotic and oral steroid usage, and number of computed tomography (CT) and magnetic resonance imaging (MRI) studies were collected for 12 months prior to and 36 months aer surgery and compared in 1-year intervals.
Results: A total of 8963 surgical patients were included. Median total direct costs fell from $4750 at preoperative baseline (95% confidence interval [CI], $4661 to $4838) to $4212 by year 3 aer surgery (95% CI, $4078 to $4346). Disease-specific costs related to conditions commonly associated with CRS—asthma, allergy, depression, and headache–all decreased in the years aer surgery; the reduction was significant for all conditions but asthma. Mean days of antibiotic usage per year decreased from 28.2
C
hronic rhinosinusitis (CRS) is a common disease with a large impact on the U.S. healthcare system. It is one of the top 20 diagnoses treated in ambulatory care, generating an estimated 11 million office visits per year.1 Management of CRS is estimated to cost the United States about $8.6 billion per year2 ; compared to national averages for all
1 Department
of Otolaryngology–Head and Neck Surgery, University of Washington, Seattle, WA; 2 Department of Surgery, University of Washington, Seattle, WA
Correspondence to: Patricia L. Purcell, MD, 1959 NE Pacific Street, Box 356515, Seattle, WA 98195; e-mail: [email protected] Funding sources for the study: NIH (National Institute on Deafness and Other Communication Disorders [NIDCD], Institutional National Research Service Award for Research Training in Otolaryngology (PLP), 2T32DC000018). Potential conflict of interest: None provided. View this article online at wileyonlinelibrary.com. Received: 11 August 2014; Revised: 17 November 2014; Accepted: 2 December 2014 DOI: 10.1002/alr.21482 View this article online at wileyonlinelibrary.com.
days before surgery to 15.9 days by year 3 aer surgery, p value
