Hospital charges and length of stay due to periapical abscess, United States 2020-2022

BACKGROUND: Periapical abscess (PA) is a preventable disease that can potentially be fatal if untreated. In the United States, an average of 300 patients die in hospital settings annually from PA, highlighting barriers to oral health care. The authors conducted a nationwide study to identify key factors for efficient hospital resource use and better patient outcomes. METHODS: The authors used data from 2020 through 2022 from the National Inpatient Sample database. All hospitalizations for a primary or secondary diagnosis of PA were examined. The characteristics of patients and hospitals were explored. To find the factors contributing to higher hospital charges and longer length of stay, multivariable linear regression models were used. RESULTS: From 2020 through 2022, there were 26,985 and 118,140 admissions for PA as a primary diagnosis and secondary diagnosis, respectively. Mean hospital charges were $35,042 and $86,600 for a primary diagnosis and a secondary diagnosis, respectively. Results of regression analysis showed that age, type of admission, race and ethnicity, insurance status, region, urban or rural status of the hospital, and comorbid conditions were related to higher charges. Length of stay, age, region, income levels, and comorbid conditions were associated with longer stays. CONCLUSIONS: PA is associated with considerable resource use when it is treated in hospitals. Concerted efforts at various levels are imperative and should be focused on the various identified contributing factors and lowering barriers to prevention and routine care. PRACTICAL IMPLICATIONS: The findings can serve as the basis for changes in practice models and policy, such as adoption of prevention-oriented and value-based care as well as in further research to reduce the disease and economic burden of PA.