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Route of Admission and Age for Hospitalized Otolaryngology Patients

Eric Muñoz, MD, MBA; Gerald Zahtz, MD; Joseph Lamantia, MD; Donald Chalfin, MD; Rudy Lackner, MD; Leslie Wise, MD

Arch Otolaryngol Head Neck Surg. 1989;115(1):87-91.

Abstract
• Hospitals and physicians face new payment mechanisms that provide incentives to study health policy, management, and economics. The purpose of this study was to analyze hospital resource consumption and outcome based on age and the route of hospital admission (emergency [ER] vs nonemergency [non-ER]). We analyzed all adult otolaryngology hospital admissions (N=1589) during a three-year period (1985 through 1987) to a large northeastern academic medical center. Hospital resource consumption, measured by hospital length of stay and total hospital cost per patient, rose with age for ER and non-ER admissions. Severity of illness, clinical resource utilization, and mortality demonstrated these same characteristics. Diagnosis related group prospective hospital payment generated financial risk for ER admissions and elderly patients. Analysis demonstrated ER admission as more predictive of subsequent hospital resource consumption and outcome with changes in age compared with non-ER admission. Our findings suggest that in the future physicians and hospitals may find that age and the route of admission may be useful in stratifying patients regarding cost and outcome.

(Arch Otolaryngol Head Neck Surg 1989;115:87-91)

Author Affiliations
From the Departments of Otolaryngology (Dr Zahtz), Emergency Medicine, Medicine, and Surgery (Drs Muñoz, Chalfin, Lackner, and Wise), Long Island Jewish Medical Center, New Hyde Park, NY, and the State University of New York-Health Science Center, Stony Brook, NY (Drs Muñoz, Wise, Zahtz, and Lamantia).

Footnotes
Accepted for publication Aug 15, 1988.

Rprint requests to Research Division, Department of Surgery, Long Island Jewish Medical Center, New Hyde Park, NY 11042 (Dr Muñoz).

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