The Cost and Inpatient Burden of Treating Mandible Fractures: A Nationwide Inpatient Sample Database Analysis

Abstract

Objectives: At the conclusion of this presentation, the participants should be able to discuss the patient demographics, hospitalization characteristics, and costs associated with the treatment of mandible fractures. Study design: Cross-sectional study. Methods: A cross-sectional analysis using the 2009 Nationwide Inpatient Sample Database to identify patients hospitalized for isolated mandible fractures. Results: 1481 patients were identified with isolated mandible fractures. The average age of patients was 31, and 93.5% were male. Forty-six percent were White, 30% African-American, 14% Hispanic, 9% other, and 1% Asian. Twelve percent of patients presented with a history of alcohol abuse, 7.2% drug abuse, and 7.7% mental illness. Forty percent were from the lowest median household income quartile, and 75% were uninsured or had Medicaid. Thirty-nine percent of patients underwent surgery within 24 hours of admission, the average length of stay (LOS) was 2.95 days, and average cost of hospitalization was $35,804. Increased LOS was associated with alcohol abuse (3.7 vs. 2.9 days, p<0.001), drug use (4.7 vs. 2.8 days, p<0.001), mental illness (3.9 vs. 2.9 days, p=0.001), and age greater than 40 years (3.8 vs. 2.7 days, p<0.001). Increased total cost was associated with drug use ($56,600 vs. $34,391, p<0.001) and alcohol abuse ($42,343 vs. $34,943, p=0.011). Conclusions: Males, persons of low socioeconomic status, and African-Americans comprise a disproportionately high percentage of mandible fracture patients treated nationally. Healthcare expenditures associated with the treatment of mandible fractures are higher for older patients, those with mental illness, and those with a history of substance abuse.