What factors influence the cost in treating maxillofacial fractures among pediatric patients?

Abstract

Purpose The objective of the following study was to determine what factors, if any, are associated with increased hospitalization charges amongst pediatric patients who sustain maxillofacial fractures. Methods This retrospective cohort study was conducted using the Kids’ Inpatient Database (KID). The primary predictor variables were a set of heterogenous variables that included patient characteristics, injury characteristics, and hospitalization outcomes. The primary outcome variable was total charges (US dollars). Linear regression was used to determine independent risk factors for increased/decreased hospital charges. Results The final sample consisted of 50,434 pediatric patients who suffered at least one facial fracture. The mean age of the study sample was 9.72 years (SD, 6.84 years). Relative to Black patients, Hispanic patients added $12,812 (P < 0.05) in hospital charges. Relative to fall, motorcycle accident (P < 0.05), car accident (P < 0.05), and firearm assault (P < 0.05) were each independently associated with increased hospital charges. Mandible fractures (P < 0.05) added $12,208 in hospital whereas malar & maxillary fractures (P < 0.05) added $8,564 in hospital charges. Most notably, panfacial fractures (P < 0.05) added $32,364 in hospital charges. Other fractures of the body were each independently associated with increased hospital charges. Several internal organ injuries were each independently associated with increased hospital charges Conclusion There is an opportunity for cost reduction in the management of pediatric maxillofacial trauma. This includes promptness in definitive repair and easy access to interpreters for non-English speaking patients. Cost-efficient approaches to patient care should be recognized and utilized to the patient and family benefit whenever possible.