Incremental Health Care Utilization and Expenditures for Chronic Rhinosinusitis in the United States

Abstract

Objectives: I determined incremental increases in health care expenditures and utilization associated with chronic rhinosinusitis (CRS). Methods: Patients with a reported diagnosis of CRS were extracted from the 2007 Medical Expenditure Panel Survey medical conditions file and linked to the consolidated expenditures file. The patients with CRS were then compared to patients without CRS to determine differences in health care utilization (office visits, emergency facility visits, and prescriptions filled), as well as differences in health care expenditures (total health care costs, office visit costs, prescription medication costs, and self-expenditures) by use of demographically adjusted and comorbidity-adjusted multivariate models. Results: An estimated 11.1 ± 0.48 million adult patients reported having CRS in 2007 (4.9% ± 0.2% of the US population). The additional incremental health care utilizations associated with CRS relative to patients without CRS for office visits, emergency facility visits, and number of prescriptions filled were 3.45 ± 0.42, 0.09 ± 0.03, and 5.5 ± 0.8, respectively (all p ≥ 0.001). Similarly, additional health care expenditures associated with CRS for total health care expenses, office-based expenditures, prescription expenditures, and self-expenditures were $772 ± $300, $346 ± $130, $397 ± $88, and $90 ± $24, respectively (all p ≥ 0.01). Conclusions: Chronic rhinosinusitis is associated with a substantial incremental increase in health care utilization and expenditures due to increases in office-based and prescription expenditures. The national health care costs of CRS remain very high, at an estimated $8.6 billion per year.