Objective
1) Integrate practice-based patient encounters using the Dartmouth Atlas Medicare database to understand practice treatments for Meniere's Disease (MD). 2) Describe differences in the practice patterns between academic and community providers for MD.
Study Design
Practice-based research database review.
Setting
“CHEER Network” academic and community providers.
Subjects and Methods
MD patient data were identified using ICD-9 and CPT codes. Demographics, unique visits, and procedures per patient were tabulated. The Dartmouth Atlas of Healthcare was used to reference regional healthcare utilization. Statistical analysis included one-way analyses of variance (ANOVA), bivariate linear regression, and Student's t-tests with significance set at p-values less than 0.05.
Results
2,071 unique patients with MD were identified from 8 academic and 10 community OHNS provider centers nationally. Average age was 56.5, 63.9% were female and 91.4% self-reported white ethnicity. There was an average of 3.2 visits per patient. Western providers had the highest average visits per patient. Midwest providers had the highest average procedures per patient. Community providers had more visits per site and per patient than academic providers. Academic providers had significantly more operative procedures per patient (p = 0.0002), compared to community providers. Healthcare Service Areas with higher total Medicare reimbursements per enrollee did not report significantly more operative procedures being performed.
Conclusion
This is the first practice-based clinical research database study to describe MD practice patterns. We demonstrate that academic OHNS providers perform significantly more operative procedures than community providers for MD, and validate this data with an independent Medicare spending database.