The cost and inpatient burden of treating mandible fractures: a nationwide inpatient sample database analysis

Abstract

Objective: To discuss patient demographics, hospitalization characteristics, and costs associated with the treatment of mandible fractures.

Study design: Cross-sectional study.

Setting: The 2009 Nationwide Inpatient Sample (NIS) database.

Subjects/methods: Patient demographics, hospital characteristics, fracture locations, and common comorbidities for patients with isolated mandible fractures were analyzed, and variables associated with increased cost and length of hospitalization stay were ascertained.

Results: A total of 1481 patients were identified with isolated mandible fractures. The average age was 32, 85.4% were male, 39% were Caucasian, and 25% African American. Forty percent were from the lowest median household income quartile, and 77% were uninsured or government funded. The average length of stay (LOS) was 2.65 days, and average hospitalization cost was $35,804. A statistically significant increased LOS was associated with alcohol abuse, drug abuse, mental illness, diabetes mellitus type 2, cardiovascular disease, HIV, and age over 40. There was a statistically significant increased total cost associated with drug abuse, alcohol abuse, mental illness, cardiovascular disease, and age over 40.

Conclusion: The average cost for treatment of mandible fractures was $35,804 per person with increased expenditures for older patients and those with a history of mental illness, cardiovascular disease, or substance abuse. To improve outcomes and reduce hospital charges, outpatient resources and inpatient protocols should be implemented to address the factors we identified as contributing to higher costs and increased hospital stay.

Keywords: facial fractures; facial plastic and reconstruction; hospital cost; isolated mandible fracture; jaw fracture; length of stay; national inpatient sample database; open reduction internal fixation.