A validated case definition for chronic rhinosinusitis in administrative data: a Canadian perspective

Rudmik, Luke; Xu, Yuan; Kukec, Edward; Liu, Mingfu; Dean, Stafford; Quan, Hude

doi:10.1002/alr.21801

Cited by 20 publications

(21 citation statements)

References 32 publications

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“…A previous study has suggested that definitions used in database studies are often too nonspecific and need to be validated. 16 Related to this is the inability of the ICD-9 coding system to distinguish CRS from recurrent acute rhinosinusitis (RARS), and it is unclear what percentage of our cohort had RARS instead of CRS. Finally, statistically significant differences with such large patient numbers may not be clinically significant.…”

Section: Discussionmentioning

confidence: 96%

Preoperative Management of Chronic Rhinosinusitis Prior to Office Balloon Sinus Dilation: A 2011–2014 MarketScan® Analysis

Jang

Abraham

Cyr

et al. 2019

Am J Rhinol�Allergy

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Background In-office balloon sinus dilation (BSD) has recently gained popularity as a surgical treatment option for chronic rhinosinusitis (CRS). However, utilization, indications, and practice patterns surrounding in-office BSD remain unclear. Objective The purpose of this study was to use a large national administrative database to assess preoperative management of CRS prior to in-office BSD. Methods Patients undergoing standalone in-office BSD from 2011 to 2014 were identified on MarketScan and compared to a control group undergoing functional endoscopic sinus surgery (FESS). Visits to the otolaryngologist, number of computed tomography (CT) scans, number of antibiotic and steroid prescriptions, and duration of time from first visit to procedure were compared. Results When compared to the FESS group, the in-office BSD group overall had fewer office visits (2.0 vs 2.2), CT scans (1.0 vs 1.1), prescriptions for antibiotics (2.0 vs 2.2), prescriptions for systemic steroids (1.5 vs 1.8), and topical steroids (1.4 vs 1.5) in the preoperative period. They also had a shorter mean duration of time between first visit and CT scan (17.5 vs 21.4 days) as well as between first visit and procedure (55.0 vs 67.8 days). All of these findings were statistically significant. Conclusion In-office BSD for CRS was overall associated with less intense management in the preoperative period when compared to FESS. Such differences may reflect ongoing shifts in practice patterns and need to be further investigated.

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Section: Discussionmentioning

confidence: 96%

Preoperative Management of Chronic Rhinosinusitis Prior to Office Balloon Sinus Dilation: A 2011–2014 MarketScan® Analysis

Jang

Abraham

Cyr

et al. 2019

Am J Rhinol�Allergy

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“…From there, patients with an index CRS diagnosis during that period were selected. Patients were considered as having CRS if CRS-related ICD diagnosis codes (ICD-9: 473.x, 471.x; ICD-10: J32.x, J33.x) appeared on at least two claims on two separate dates, as described by Rudmik et al [ 8 ] From this cohort, patients with continuous one-year pre-index and two-year post-index enrollment were included. A one-year pre-index washout period was implemented to capture patients with a new CRS diagnosis.…”

Section: Methodsmentioning

confidence: 99%

Healthcare Resource Utilization for Chronic Rhinosinusitis in Older Adults

et al. 2021

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Objectives: Chronic rhinosinusitis (CRS) is a common and costly health problem in the United States. While often associated with younger adults, CRS can affect the elderly. As the aging population increases in the United States, the cost burden of CRS in older adults is important to assess. The objective of this study is to characterize healthcare resource utilization (HCRU) and healthcare expenditure (HCE) for CRS in this population. Methods: Patients meeting criteria for CRS with three years of continuous data were identified on IBM® Marketscan Research Databases over a five-year period (2013–2017). Medication utilization, outpatient visits, surgery, and expenditures related to CRS were assessed for older adults (>65) and compared with other age groups. As a secondary analysis, multivariable generalized linear models were utilized to compare HCE while adjusting for baseline medication utilization. Results: A total of 238,825 patients met the inclusion criteria, of which 20,927 were older adults. Older adults had the highest overall prevalence of nasal polyps (10%) and asthma (16%) among adult groups. Surgery rate was lower than other adult groups, but medication utilization was the highest. Mean overall HCE at two years was highest in older adults (USD 2545 vs. 2298 in young adults). However, HCE was highest for the young adult group after adjusting for baseline medication usage. Conclusion: Older adults had a higher rate of CRS-related co-morbidities as well as the highest CRS-related medication utilization and unadjusted two-year HCE. Although the reasons for this are unclear, possibilities include greater disease severity and preference for medical versus surgical management. HCE for CRS is expected to increase as the aging population grows.

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“…Both adult and pediatric patients with an initial CRS diagnosis, or index diagnosis, between January 1st, 2014 and December 31st, 2015 were included. Patients were considered as having CRS if CRS‐related ICD diagnosis codes (ICD‐9: 473.x, 471.x; ICD‐10: J32.x, J33.x) appeared on at least two claims on two separate dates, as described by Rudmik et al 10 The index date was defined as the first date with a claim related to a CRS diagnosis, regardless of any provider in any setting. From this cohort, patients with continuous 1‐year pre‐index and 2‐year post‐index enrollment were included, for a total of 3 years of continuous data.…”

Section: Methodsmentioning

confidence: 99%

Geographic Variations in Healthcare Utilization and Expenditure for Chronic Rhinosinusitis: A Population‐Based Approach

et al. 2021

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Objectives/Hypothesis: Chronic rhinosinusitis (CRS) is a common and costly health problem in the United States. A better understanding of healthcare resource utilization (HCRU) and healthcare expenditure (HCE) pertaining to CRS is required. The objective of this study is to investigate geographic variations in HCRU and HCE for CRS.Study Type/Design: Retrospective study of administrative database. Methods: Patients meeting pre-defined diagnostic criteria for CRS with continuous 1-year pre-index and 2-year postindex data were identified on IBM ® Marketscan Research Databases over a 5-year period (2013)(2014)(2015)(2016)(2017). Data pertaining to demographics, HCRU, and HCE were analyzed according to geographic region. Multivariable generalized linear models accounted for age, sex, baseline medication utilization, and co-morbidities.Results: About 237,969 patients were included. Antibiotics were the most commonly prescribed medication (95%). Surgery rate (11%), immunotherapy (9.2%), oral steroid use (66%), and antibiotic utilization (mean 6.3 prescriptions) were highest in the South. However, visits with an otolaryngologist were considerably higher in the Northeast (62%). The Northeast region had the highest mean HCE ($2,449), which was 13% greater than HCE for the North Central region ($2,172). HCRU and HCE were higher in urban areas across all metrics, with 2-year HCE being 18% greater in urban areas ($2,374 vs. $2,019). Significant geographic variation in HCE was observed even after adjusting for covariates.Conclusion: Significant geographic variations in HCRU and HCE exist for CRS even after adjusting for covariates. Future studies are needed to help direct quality improvement and cost-saving efforts as well as efficient resource allocation in an era of value-based care.

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A validated case definition for chronic rhinosinusitis in administrative data: a Canadian perspective

Cited by 20 publications

References 32 publications

Preoperative Management of Chronic Rhinosinusitis Prior to Office Balloon Sinus Dilation: A 2011–2014 MarketScan® Analysis

Preoperative Management of Chronic Rhinosinusitis Prior to Office Balloon Sinus Dilation: A 2011–2014 MarketScan® Analysis

Healthcare Resource Utilization for Chronic Rhinosinusitis in Older Adults

Geographic Variations in Healthcare Utilization and Expenditure for Chronic Rhinosinusitis: A Population‐Based Approach

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