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Table 2 HRU and costs associated with AOM (including recurrent AOM and simple AOM) among commercially and Medicaid insured children aged < 18 years (2014–2018)

From: Economic burden of acute otitis media, pneumonia, and invasive pneumococcal disease in children in the United States after the introduction of 13-valent pneumococcal conjugate vaccines during 2014–2018

 

Commercially insured population

Medicaid insured population

Overall AOM

Simple AOM

Recurrent AOM

Overall AOM

Simple AOM

Recurrent AOM

Total number of episodes

N = 6,181,608

N = 5,151,249

N = 1,030,359

N = 5,599,089

N = 4,646,941

N = 952,148

HRU

 IP admission

  Proportion of episodes with at least 1 IP admission, %

0.03

0.03

0.03

0.06

0.06

0.06

  Total LOS per episode1, mean (SD)

3.4 (7.8)

3.5 (7.9)

3.2 (7.4)

3.8 (13.1)

3.9 (14.1)

3.1 (5.0)

 ER visit

  Proportion of episodes with at least 1 ER visit, %

12.8

13.8

7.9

28.2

30.1

18.9

  Number of ER visits per episode1, mean (SD)

1.0 (0.2)

1.0 (0.2)

1.1 (0.3)

1.0 (0.2)

1.0 (0.2)

1.1 (0.3)

 OP visit

  Proportion of episodes with at least 1 OP visit, %

88.8

87.7

93.9

75.0

72.9

85.1

  Number of OP visits per episode1, mean (SD)

1.2 (0.7)

1.1 (0.7)

1.3 (1.0)

1.2 (1.0)

1.1 (1.0)

1.3 (1.0)

 OP antibiotic prescriptions

  Proportion of episodes with at least 1 prescription, %

72.0

73.7

63.3

82.2

84.2

72.8

  Number of antibiotic prescriptions per episode1, mean (SD)

1.2 (0.6)

1.1 (0.5)

1.3 (0.7)

1.1 (0.5)

1.1 (0.5)

1.2 (0.5)

 AOM surgical procedures

  Proportion of episodes with at least 1 procedure, %

3.8

2.1

12.4

3.8

2.2

11.4

  Number of surgical procedures per episode1, mean (SD)

1.0 (0.2)

1.0 (0.2)

1.0 (0.1)

1.0 (0.2)

1.1 (0.3)

1.0 (0.1)

Healthcare costs per episode (in 2019 USD)2

 Total costs, mean (SD)

$329 ($1505)

$268 ($1416)

$633 ($1859)

$184 ($1524)

$168 ($1641)

$265 ($713)

 IP admission costs1, mean (SD)

$17,418 ($60,758)

$17,329 ($62,040)

$17,911 ($53,241)

$8235 ($58,223)

$8519 ($63,321)

$6735 ($10,749)

 ER visit costs1, mean (SD)

$387 ($698)

$384 ($670)

$413 ($902)

$162 ($214)

$161 ($211)

$166 ($234)

 OP visit costs1, mean (SD)

$189 ($637)

$164 ($539)

$307 ($964)

$121 ($369)

$109 ($332)

$171 ($494)

 OP pharmacy costs1, mean (SD)

$29 ($65)

$26 ($55)

$43 ($102)

$30 ($65)

$27 ($60)

$40 ($86)

 AOM surgical procedure costs1, mean (SD)

$2276 ($3100)

$2290 ($3740)

$2265 ($2437)

$468 ($1737)

$483 ($2270)

$453 ($1005)

  1. 1The HRU costs are the total payments from payers or out-of-pocket payments by patients. The HRU costs per episode for IP admission, ER visit, OP visit, and OP pharmacy were calculated among patients who received the service rather than the total number of episodes. Costs are reported in 2019 USD
  2. 2Both capitated and non-capitated plans were included in the HRU cost analyses. Non-capitated plans include EPO, PPO, POS, HDHP, and CDHP. Capitated plans include HMO
  3. Abbreviations: AOM Acute otitis media, CDHP Consumer directed health plan, EPO Exclusive provider organization, ER Emergency room, FFS Fee-for-service, HDHP High-deductible health plan, HMO Health maintenance organization, HRU Healthcare resource utilization, IP Inpatient, IPD Invasive pneumococcal disease, LOS Length of stay, OP Outpatient, PCV Pneumococcal conjugate vaccine, POS Point of service, PPO Preferred provider organization, SD Standard deviation, USD US dollars
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BMC Health Services Research

ISSN: 1472-6963

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