Surgically Treated Severe Odontogenic Infections: A Large Cost to the United States Hospital System and Patients

Author(s): Timothy W. Neal, Yousef Hammad, Brian R. Carr, Thomas Schlieve

Objectives
This purpose of this study was to analyze the cost of surgically treated severe odontogenic infections to both the patient and the hospital system.

Materials and Methods
This retrospective chart review assessed data of patient hospital charts surgically treated for severe odontogenic infections in the operating room and admitted for greater than one day. Hospital charts of consecutive inpatients admitted from the ED to the University of Texas Southwestern Medical Center and Parkland Memorial Hospital for treatment from January 1st 2016 to December 31st 2020, were reviewed. Patients with infections of non-odontogenic origin were excluded. The specific outcome measures included total hospital stay cost, amount not collected, hospital charity adjustments, insurance type, length of stay, number of infected spaces, number of operating room visits, imaging ordered, and preadmission antibiotics.

Results
Data from 144 consecutive hospital charts were analyzed. The total billed cost of stay across all study years was $6,888,326.52, the average billed cost per hospital stay was $47,835.60, and the amount not collected was $2,864,857.82. Of the total billed cost, $2,107,692.15 was covered by hospital charity. Only $777,276.43 (11.3%) of the total $6,888,326.52 billed was collected by the hospital.

Conclusions
Patients that are treated for severe odontogenic infections incur a large hospital bill that could have been avoided. Often, a very small percentage of this bill is collected by the hospital.