A reply to R. West’s comments on Leynes, Marsh, Hicks, Allen, and Mayhorn

Abstract

Quantify the resource utilization associated with airway foreign bodies in children in the United States using a national database and report observed trends over time. Study type: Cross-sectional analysis of national inpatient database with weighted estimates.The KID database (2000–2009).ICD-9-DM codes for foreign body aspiration were used to identify patients to be included for investigation. Admission rates and charges were aggregated and compared among geographic region, location, and teaching hospital status. These factors were then also trended over time.From 2000 to 2009, airway foreign body diagnoses in children accounted for an estimated 4000 to 5000 admissions, resulting in a mean admission rate of 6.6 per 10,000 pediatric patients annually. Charges related to airway foreign bodies in children rose from a total of $93 million to $486 million in the observed period. There is an increasing trend over time of total charges per patient. Charges appear to be higher in urban locations and teaching hospitals.The public health and economic burden of pediatric airway foreign bodies appears to be rising. Further investigation may be helpful to examine factors that may be contributing to increasing charges and creating strategies to improve cost effectiveness, as well as why there seems to be increased resource utilization in urban locations and teaching hospitals.