Economic Burden Associated With Nasal Polyposis Recurrence Among Commercially Insured Patients in the United States

Otolaryngol Head Neck Surg. 2023 Jan;168(1):65-73. doi: 10.1177/01945998221089187.


Objective: To compare health care resource utilization (HRU) and costs among commercially insured patients with nasal polyposis (NP) with and without recurrence after endoscopic sinus surgery (ESS).

Study design: Retrospective matched cohort study.

Setting: Adults with initial ESS or an NP excision after a new NP diagnosis were identified in Optum's Clinformatics Data Mart Database (October 1, 2014-December 31, 2019).

Methods: The index date was the date of NP recurrence, identified with a claims-based algorithm for the recurrent cohort, or a random date for the nonrecurrent cohort. Patients in both cohorts were matched 1:1 on baseline characteristics (12 months preindex) via propensity scores and exact matching factors. Annual HRU and costs (2019 US$) were compared between the matched cohorts at 12 months postindex.

Results: NP recurrence was identified among 3343 of 16,693 patients with initial ESS; after matching, each cohort comprised 1574 patients (median age, 54 years; 40% female) with similar baseline health care costs (recurrent, $34,420; nonrecurrent, $33,737). At 12 months postindex, the recurrent cohort had higher HRU, including 36% and 51% more outpatient and emergency department visits, respectively (all P < .01). Mean health care costs were $9676 higher in the recurrent cohort ($24,039) relative to the nonrecurrent cohort ($14,363, P < .01). The mean cost difference between cohorts was driven by $8211 in additional outpatient costs, as well as $6062 in additional NP-related outpatient costs, in the recurrent cohort (all P < .01).

Conclusion: NP recurrence is associated with a substantial economic burden, which appears to be driven by outpatient services.

Keywords: costs; economic burden; endoscopic sinus surgery; health care resource utilization; nasal polyposis; recurrence.

MeSH terms

  • Adult
  • Cohort Studies
  • Female
  • Financial Stress*
  • Health Care Costs
  • Humans
  • Male
  • Middle Aged
  • Nasal Polyps* / surgery
  • Outpatients
  • Retrospective Studies
  • United States