Unplanned Re‐admissions in ENT: How Much Do They Cost?

Abstract

Objective: Unplanned hospital re-admissions are a significant source of morbidity and mortality and are a major fiscal burden to the National Health Service. The cost of re-admissions to ENT services has not previously been described. We present an audit, evaluating the cost per patient for ENT re-admissions in our department. Method: A prospective audit of all ENT patients who were re-admitted within 28 days of initial discharge over a 3-month period was observed. Cost was calculated using the Department of Health reference books. Results: n = 24 (17 emergencies, 7 elective) Emergencies: 53% otitis externa (7/17) and tonsillitis (2/17); all returned due to pain. Elective: 86% posttonsillectomy, including hemorrhage (3/7) and pain (3/7). Cost: Total: £25’237.50 (£1051.56 per patient) Otitis externa: £8983.61 (£1122.95 per patient) Post-tonsillectomy bleed/pain: £4670.21 (£778.37 per patient) Otitis externa/post tonsillar combo: £9761 (39% of total cost). Conclusion: Unplanned re-admissions to ENT cost £25,237.50 over three months. Nearly 40% of this was due to otitis externa, tonsillitis, or as a postoperative complication of tonsillectomy due to suboptimal analgesia. We would recommend greater awareness of departmental caseloads as a means to develop targeted strategies in reducing re-admissions.