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Childhood ear infections come with almost $3 billion price tag

Ear infections (acute otitis media) are the most common illness among children of preschool age and younger in the United States
Ear infections (acute otitis media) are the most common illness among children of preschool age and younger in the United States
Robin Wulffson, M.D.

UCLA and Harvard researchers conducted a study to determine the financial impact of childhood ear infections (acute otitis media). They found that acute otitis media is associated with substantial increases in direct costs incurred by both consumers and the healthcare system. They found that the high prevalence of this condition throughout the United States, it accounts for approximately $2.88 billion in added healthcare expenses annually and is a significant healthcare utilization concern. They published their findings in the January edition of the journal The Laryngoscope.

Acute otitis media is the most common illness among children of preschool age and younger in the United States. This is primarily due to the fact that children in this age group have immature middle-ear drainage systems, higher exposure to respiratory illnesses, and undeveloped immune systems. In addition, acute otitis media, is the most common reason for antibiotic use among all children; thus, the costs associated with acute otitis media are currently under more scrutiny than ever by healthcare and government administrators, primarily because of today’s political and economic climate, overburdened healthcare resources, and cost-containment efforts.

The study authors note that estimates of the economic impact of acute otitis media have been expressed in the past, the new study is the first to use a national population database, which provides a direct, head-to-head comparison of expenditures for pediatric patients diagnosed with ear infections and similar patients without ear infections.

“Although the annual incidence of ear infection may be declining in the U.S., the number of kids affected remains high, and the public health implications of AOM are substantial,” noted study co-author Dr. Nina Shapiro, director of pediatric otolaryngology at Mattel Children’s Hospital UCLA and a professor of head and neck surgery at the David Geffen School of Medicine at UCLA. She added, “As our healthcare system continues to be vigorously discussed around the nation, efforts to control costs and allocate resources appropriately are of prime importance.”

The study group comprised data from 81.5 million children under the age of 18 that was obtained from the 2009 Medical Expenditure Panel Survey, which is a national survey conducted by the Agency for Health Research and Quality; the survey provides a benchmark data-set specifically designed for the assessment of healthcare costs. The researchers found that among the study sample, 8.7 million of the 81.5 million had received care for ear infections. The rates of visits to the doctor’s office, refills of prescription medications, and healthcare costs associated with doctor visits were then compared between children diagnosed ear infections and those that were not. The rates were adjusted for age, sex, region, race, ethnicity, insurance status and co-morbidities (other health problems).

The investigators found that, compared to children without a history of ear infections, children with ear infections had an average of two additional outpatient visits, 0.2 additional emergency department visits and 1.6 additional prescriptions filled. These ear infections were associated with an incremental increase of $314 per child annually for outpatient healthcare and an average of $17 in additional costs for medications. This resulted in an overall $2.88 billion annual cost for ear infections. Dr. Shapiro noted, “Although certain immunizations that target infection-causing bacteria may play a role in slightly reducing the overall rate of ear infections, millions of young kids will still have them. The take-home message is that the common ear infection is an extremely costly entity with significant financial burdens on the health care system.” Dr. Shapiro and her colleagues plan future studies on the healthcare cost associated with acute otitis media. These studies will analyze the indirect costs, such as work and school days missed, gasoline costs, and parking charges for outpatient visits.

Unfortunately, cold and allergy medications do not appear to prevent otitis media. In addition, currently, there is no vaccine that can prevent the disease. However, it is important to consult your healthcare provider and make sure your child’s vaccinations are up-to-date. There are certain factors that seem to increase the chances of otitis media developing in some children. These include: living in a home where cigarettes are smoked and nursing with a bottle while lying down.

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