Surgical Treatment of XXXX : A National Perspective.

@entity1 @entity542 @entity174 @entity130
INTRODUCTION: @entity542 is the most common cause of death because of injury in @entity1 , and @entity130 alone is the leading cause of morbidity and mortality in pediatrics. This study aimed to characterize the demographics and economic burden associated with the surgical and nonsurgical repair of craniofacial @entity174 in the pediatric inpatient population in the United States. METHODS: A retrospective cohort study was performed using the 2012 Kids' Inpatient Database which identified 20,070 @entity1 who had a skull or facial @entity174 , of whom 6395 (31.9%) were treated surgically. Epidemiologic @entity1 and hospital data were analyzed as potential determinants of surgical treatment, prolonged hospitalizations, and higher charges. RESULTS: Pediatric craniofacial @entity174 are estimated to represent  1.2 billion of national healthcare expenditures annually. The average @entity1 charge for surgical treatment of a craniofacial @entity174 in the pediatric population is  84,849 compared with  52,490 for nonsurgical management (P<0.001), and the average length of stay was longer for surgical repair when compared with nonsurgical management for craniofacial @entity174 (5.3 days versus 4.6 days, P<0.001). @entity1 who were older, African American, had nonprivate insurance, whose @entity174 was caused by external @entity130 , and who were treated in an urban hospital had an independently increased likelihood of surgical repair of craniofacial @entity174 . @entity1 who were older, female, insured, of lower income brackets, whose @entity174 was caused by a motor vehicle accident, who had surgical treatment of their craniofacial @entity174 , and who were treated in hospitals in the South, Midwest, or West, teaching hospitals, and government-owned hospitals had an independent risk for a prolonged hospitalization. @entity1 who were older, Caucasian, insured, whose @entity174 was caused by a motor vehicle accident, and who were treated in hospitals in the South, teaching hospitals, pediatric hospitals, larger hospitals, and government-owned hospitals had an independent risk for increased @entity1 charges. CONCLUSIONS: Craniofacial @entity174 in the pediatric population represent a large economic burden to the @entity1 and family, as well as the healthcare system as a whole. The identified @entity1 and hospital demographics that are associated with prolonged hospital stays and higher @entity1 charges may represent potential barriers to care, and additional research to elucidate these factors is warranted.
