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. 2014 Aug;53(9):865-73.
doi: 10.1177/0009922814533592. Epub 2014 May 9.

Payment analysis of two diagnosis and management approaches of acute otitis media

Janet R Casey  1 , Michael E Pichichero  2
Affiliations

Payment analysis of two diagnosis and management approaches of acute otitis media

Janet R Casey et al. Clin Pediatr (Phila). 2014 Aug.

Abstract

We determined the cost of care for 2 diagnosis and management approaches for acute otitis media (AOM) among children 6 to 30 months old. A case-control design was used. Cases included 208 children diagnosed with AOM based on a bulging tympanic membrane (TM) and treated with amoxicillin/clavulanate. Controls (5:1 ratio) included 1020 children with AOM diagnosed not requiring bulging of the TM and treated with amoxicillin. Fewer cases (49%) than controls (69%) were diagnosed with AOM (P < .001), fewer were diagnosed with recurrent AOM or AOM treatment failure (0.34 vs 1.6/child; P < .0001), and fewer had insertion of tympanostomy tubes (6.3% vs 14.8%) due to recurrent AOM (P < .0001). The combined direct payments and indirect costs for management of AOM were $539/case versus $1,023/control. Using Rochester NY payments generalized to the US birth cohort, this case diagnosis and treatment strategy could save $1.008 billion per year.

Keywords: acute otitis media; antibiotics; guidelines; payment analysis; tympanostomy tubes.

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Conflict of interest statement

The authors declare no conflicts of interest.

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