Background

Recurrent cellulitis is diagnosed in 22% to 49% of all cellulitis cases, but little is known about the costs associated with these cases.

Objective

To characterize patients with recurrent cellulitis in the outpatient setting and estimate the associated costs.

Methods

A retrospective chart review was conducted for adult patients who presented to the outpatient facilities at our institution from January 1, 2007, to December 31, 2011, with recurrent cellulitis. Data provided by the Centers for Medicare and Medicaid Services were used.

Results

A total of 157 patients were identified; 56% were male, with a mean age of 62.7 years. The mean number of episodes of cellulitis per patient was 3. Antibiotics were prescribed for all patients with a diagnosis of recurrent cellulitis, with 93% treated with oral antibiotics and 17.6% treated with intravenous antibiotics. A total of 1081 laboratory and 175 radiologic imaging tests were ordered. The minimum average cost per cellulitis episode was $586.91; the average cost per visit was $292.50.

Limitations

Retrospective study; use of a single, large academic institution; and utilization of cost estimates that may not adequately reflect the variation of costs across closed-system sites or geographic regions. There was no accounting for the nonfinancial or opportunity costs associated with hospitalization, such as lost days of employment or child care and any long-term morbidities, among others.

Conclusions

Recurrent cellulitis in the outpatient setting costs about $586.91 per episode. Although there is no criterion standard for diagnosis or treatment of cellulitis, our analysis demonstrates the need for more evidence-based management to achieve better outcomes and reduce the significant health care costs.

中文翻译：

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估算与门诊环境中复发性蜂窝织炎相关的医疗保健费用

背景

在所有蜂窝组织炎病例中，诊断为复发性蜂窝组织炎的比例为22％至49％，但与这些病例相关的费用知之甚少。

客观的

在门诊患者中表征复发性蜂窝织炎的患者并估算相关费用。

方法

对2007年1月1日至2011年12月31日在我院门诊就诊的复发性蜂窝织炎的成年患者进行回顾性图表审查。使用了医疗保险和医疗补助服务中心提供的数据。

结果

总共确定了157例患者；男性为56％，平均年龄为62.7岁。每例蜂窝织炎的平均发作次数为3。所有诊断为复发性蜂窝织炎的患者均开了抗生素处方，其中93％口服抗生素治疗，17.6％静脉注射抗生素治疗。总共订购了1081个实验室和175个放射成像检查。每例蜂窝织炎的最低平均成本为586.91美元；平均每次造访费用为$ 292.50。

局限性

回顾性研究；使用单一的大型学术机构；以及可能无法充分反映跨封闭系统站点或地理区域的成本变化的成本估算。没有考虑与住院相关的非财务或机会成本，例如失去工作或育儿的天数以及任何长期发病率等。

结论

门诊复发性蜂窝织炎每次发作的费用约为586.91美元。尽管目前尚无诊断或治疗蜂窝织炎的标准标准，但我们的分析表明，需要更多的循证管理以取得更好的结果并减少可观的医疗费用。