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Laryngoscope. 2014 Jan;124(1):301-5. doi: 10.1002/lary.24190. Epub 2013 May 31.

Incremental health care utilization and costs for acute otitis media in children.

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UCLA Department of Head and Neck Surgery, David Geffen School of Medicine at UCLA, Los Angeles, California.



Determine the incremental health care costs associated with the diagnosis and treatment of acute otitis media (AOM) in children.


Cross-sectional analysis of a national health-care cost database.


Pediatric patients (age < 18 years) were examined from the 2009 Medical Expenditure Panel Survey. From the linked medical conditions file, cases with a diagnosis of AOM were extracted, along with comorbid conditions. Ambulatory visit rates, prescription refills, and ambulatory health care costs were then compared between children with and without a diagnosis of AOM, adjusting for age, sex, region, race, ethnicity, insurance coverage, and Charlson comorbidity Index.


A total of 8.7 ± 0.4 million children were diagnosed with AOM (10.7 ± 0.4% annually, mean age 5.3 years, 51.3% male) among 81.5 ± 2.3 million children sampled (mean age 8.9 years, 51.3% male). Children with AOM manifested an additional +2.0 office visits, +0.2 emergency department visits, and +1.6 prescription fills (all P <0.001) per year versus those without AOM, adjusting for demographics and medical comorbidities. Similarly, AOM was associated with an incremental increase in outpatient health care costs of $314 per child annually (P <0.001) and an increase of $17 in patient medication costs (P <0.001), but was not associated with an increase in total prescription expenses ($13, P = 0.766).


The diagnosis of AOM confers a significant incremental health-care utilization burden on both patients and the health care system. With its high prevalence across the United States, pediatric AOM accounts for approximately $2.88 billion in added health care expense annually and is a significant health-care utilization concern.


Acute otitis media; children; health care expenditures; health care utilization; incremental analysis

[Indexed for MEDLINE]

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