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. 2018 May 2;18(1):318.
doi: 10.1186/s12913-018-3139-1.

Trends in healthcare utilization and costs associated with acute otitis media in the United States during 2008-2014

Sabine Tong  1 , Caroline Amand  2 , Alexia Kieffer  3 , Moe H Kyaw  4
Affiliations

Trends in healthcare utilization and costs associated with acute otitis media in the United States during 2008-2014

Sabine Tong et al. BMC Health Serv Res. .

Abstract

Background: Acute otitis media (AOM) is the most common cause of pediatric medical visits and antibiotic prescriptions worldwide, but its current impact on the US healthcare system is not clear. The aim of this study was to investigate changes in the incidence of AOM from 2008, just before 13-valent pneumococcal conjugate vaccine was introduced, to 2014 using US insurance records in the Truven MarketScan® database. The study also examined the costs associated with index AOM events during the two most recent years for which data were available (2013-2014).

Methods: AOM cases in the MarketScan database during 2008-2014 were identified using ICD9 diagnosis codes 381.xx and 382.xx. Incidence rates of healthcare utilization related to the index AOM episode were calculated using the annual number of enrolled person-years as the denominator and the number of individuals with AOM as the numerator. AOM-associated costs were calculated as the mean payment per episode during the 2 years from 2013 to 2014.

Results: The overall annual rate of AOM-related healthcare utilization was 60.5 per 1000 person-years and changed little from 2008 to 2014 (range, 58.4-62.6). Most of this was due to office/outpatient visits (55.7 [range, 52.0-58.8] per 1000 person-years). Emergency department/urgent care visits (4.7 [range 3.7-6.3] per 1000 person-years) and hospitalization (0.0 [range, 0.0-0.1] per 1000 person-years) contributed little. The rate of AOM-related healthcare utilization per 1000 person-years was highest in the youngest children and declined with age (474.3 for < 1 year, 503.9 for 1 year, 316.3 for 2-4 years, 94.9 for 5-17 years, 33.1 for 18-49 years, 28.6 for 50-64 years, 23.7 for 65-74 years, 20.2 for 75-84 years, and 16.1 for ≥85 years). The mean cost per AOM episode in 2013-2014 (95% confidence interval) was $199.0 (198.4-199.6) for office or outpatient visits, $329.6 (328.2-331.0) for emergency department/urgent care visits, and $1592.9 (1422.0-1763.8) for hospitalization.

Conclusions: In the US, AOM-associated healthcare utilization and costs remain substantial. More effective preventive measures such as new vaccines are needed to reduce the burden of AOM.

Keywords: Acute otitis media; Epidemiology; Healthcare cost; Healthcare utilization; Pneumococcal conjugate vaccine; United States.

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Conflict of interest statement

Ethics approval and consent to participate

Not applicable.

Competing interests

C.A. is an employee of Sanofi, and A.K. and M.H.K. are employees of Sanofi Pasteur. S.T. was paid by Sanofi Pasteur for statistical analyses included in this manuscript.

Publisher’s Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Figures

Fig. 1
Fig. 1
Seasonality of AOM cases in the US, 2008–2014
See this image and copyright information in PMC

References

    1. Monasta L, Ronfani L, Marchetti F, Montico M, Vecchi Brumatti L, Bavcar A, et al. Burden of disease caused by otitis media: systematic review and global estimates. PLoS One. 2012;7:e36226. doi: 10.1371/journal.pone.0036226. - DOI - PMC - PubMed
    1. Vergison A, Dagan R, Arguedas A, Bonhoeffer J, Cohen R, Dhooge I, et al. Otitis media and its consequences: beyond the earache. Lancet Infect Dis. 2010;10:195–203. doi: 10.1016/S1473-3099(10)70012-8. - DOI - PubMed
    1. Leung AKC, Wong AHC. Acute otitis Media in Children. Recent Patents Inflamm Allergy Drug Discov. 2017;11:32–40. - PubMed
    1. Grabenstein JD, Klugman KP. A century of pneumococcal vaccination research in humans. Clin Microbiol Infect. 2012;18(Suppl 5):15–24. doi: 10.1111/j.1469-0691.2012.03943.x. - DOI - PubMed
    1. Cohen R, Varon E, Doit C, Schlemmer C, Romain O, Thollot F, et al. A 13-year survey of pneumococcal nasopharyngeal carriage in children with acute otitis media following PCV7 and PCV13 implementation. Vaccine. 2015;33:5118–5126. doi: 10.1016/j.vaccine.2015.08.010. - DOI - PubMed

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