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What factors influence the cost of orthognathic surgery among patients in the US?

Published:November 16, 2022DOI:https://doi.org/10.1016/j.oooo.2022.11.007

      Clinical Relevance

      • No study has yet to analyze the cost of orthognathic surgery at a nationwide level. The factors that influence the cost of orthognathic surgery and whether they are modifiable are explored in this study.

      Abstract

      Purpose

      The purpose of our study is to analyze what factors influence the cost of orthognathic surgery performed within the US.

      Study Design

      This retrospective cohort study was completed using the Kids’ Inpatient Database (KID) from 2000 to 2012 on all patients aged 14-20 years who had undergone orthognathic surgery. There predictor variables included patient and hospitalization characteristics. The primary outcome variable was hospital charge (US dollars). Multivariate linear regression was conducted to determine independent predictors for increased/decreased hospital charge.

      Results

      The final sample consisted of 14,191 patients (mean age, 17.4 ± 1.6 years; females, 59.2%). Each additional day in the hospital added $8,123 in hospital charges (p < 0.01). Relative to mandibular osteotomy, maxillary osteotomy (+$5,703, p < 0.01) and bi-maxillary osteotomy (+$9,419, p < 0.01) were each associated with increased hospital charges. Genioplasty (+$3,499, p < 0.01), transfusion of packed cells (TPC) (+$11,719, p < 0.01), continuous invasive mechanical ventilation (CIMV) < 96 hours (+$23,502, p < 0.01), CIMV ≥ 96 hours (+$30,901, p < 0.01) were each associated with significantly increased hospital charges. OSA added $6,560 in hospital charges (p < 0.01).

      Conclusions

      Maxillary osteotomy and bi-maxillary surgery were each associated with significantly increased charges relative to mandibular osteotomy. Concomitant genioplasty, TPC, CIMV, and OSA each significantly increased charges. Each additional day to the length of stay (LOS) significantly increased charges.

      Key Words

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