Abstract
Objective: 1) Learn about the epidemiology of recurrent acute rhinosinusitis (RARS). 2) Understand healthcare costs attributable to RARS as a potentially underdiagnosed form of chronic rhinosinusitis.
Method: Medical claims data (2003-2008) from a large payer database were analyzed. Adult patients with RARS (defined as at least 4 acute rhinosinusitis [ARS] claims each with a filled oral antibiotic prescription in a 12-month period) were extracted. Diagnostic procedures, surgery rates, and medical costs were determined.
Results: A total of 4,588 patients were identified (mean age, 43.5 years; 72.1% female) among 13.1 million patients, for a point prevalence of 0.035%, which remained consistent across years. After 1, 2, and 4 years, 2.4%, 5.4%, and 9.2% of patients subsequently received nasal endoscopy and 11.4%, 23.5%, and 39.9% received paranasal sinus computed tomography, respectively. Similarly, 0.2%, 2.0%, and 4.1% underwent endoscopic sinus surgery at these same intervals. Average total healthcare costs related to RARS averaged $1207/patient-year. Antibiotic and nasal prescription costs averaged $210 and $452, and an average of 3.8 antibiotics were filled per patient-year with RARS.
Conclusion: RARS may affect approximately 1 in 3000 adults. Despite significant health care costs over $1000/year per individual patient with RARS, nasal endoscopy and computed tomography are not commonly obtained early after potential diagnosis. RARS is likely an underdiagnosed condition warranting further study.
Get full access to this article
View all access options for this article.