Author(s)
Terral Patel, MD
Manasa Melachuri, MD
Jonas Johnson, MD
Daniel Carmen, BS
Michael Corcoran, BS
Affiliation(s)
University of Pittsburgh Medical Center;
Abstract:
Educational Objective: At the conclusion of this presentation, the participants should be able to have an idea on the general healthcare and out of pocket costs for common otolaryngology diagnoses as well as understand the complexities and burden of healthcare costs in the United States.
Objectives: In 2021, healthcare spending consumed nearly 20% of the overall GDP in the United States and was the leading cause of medical debt among families and individuals. However, understanding the potential financial toxicity on an individual patient is complicated by multiple factors. This study presents healthcare costs associated with common otolaryngology diagnoses from a single integrated delivery and finance system (IDFS) over five years.
Study Design: Retrospective review.
Methods: Patients with coverage from a single provider in 2014 with chronic rhinosinusitis (CRS), obstructive sleep apnea (OSA), recurrent acute otitis media (RAOM), sensorineural hearing loss (SNHL), voice and resonance disorders (VRD), and oral cancer were identified. Costs associated with those diagnoses were tracked and analyzed.
Results: 30,851 members were identified in the year 2014 and followed until the end of 2019. While patients with oral cancer ($14,518.96) followed by OSA ($2,477.30) and SNHL ($2,138.08) faced the highest total healthcare charges, patients with OSA ($419.99) and oral cancer ($400.47) demonstrated comparable out of pocket costs over five years. The costliest services included ambulatory surgeries ($222.12 for CRS and $212.30 for SNHL), medical therapies and equipment ($5230.48 for oral cancer and $738.80 for OSA), and professional care ($2822.48 for oral cancer).
Conclusions: As confirmed by previous studies, the healthcare cost of oral cancer and OSA is burdensome. Interestingly, out of pocket cost in the first year after diagnosis is the highest among all conditions and tapers off in the following years. Further studies are needed to improve transparency of common healthcare costs in otolaryngology and guide the need for cost effectiveness studies.