{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,20]],"date-time":"2026-02-20T06:35:57Z","timestamp":1771569357663,"version":"3.50.1"},"reference-count":29,"publisher":"Wiley","issue":"3","license":[{"start":{"date-parts":[[2020,5,26]],"date-time":"2020-05-26T00:00:00Z","timestamp":1590451200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["aao-hnsfjournals.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Otolaryngol.--head neck surg."],"published-print":{"date-parts":[[2020,9]]},"abstract":"<jats:sec><jats:title>Objective<\/jats:title><jats:p>To identify the dominant clinical factors associated with increased 1\u2010year charges in treating head and neck cancer.<\/jats:p><\/jats:sec><jats:sec><jats:title>Study Design<\/jats:title><jats:p>Retrospective review.<\/jats:p><\/jats:sec><jats:sec><jats:title>Setting<\/jats:title><jats:p>Single academic institution.<\/jats:p><\/jats:sec><jats:sec><jats:title>Subjects and Methods<\/jats:title><jats:p>We retrospectively reviewed 1\u2010year charges for 196 consecutive patients with head and neck cancer (HNC) who were treated exclusively at our institution. We analyzed charges by department as well as factors associated with increased charges per multivariable regression.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>The mean age was 59.6 years (SD, 14.9). Most of the population was male (64%), white (70%), and commercially insured (46%). The most common primary sites were the oropharynx (25%; 76%, HPV positive), skin (19%), and thyroid (17%). Eighty\u2010three percent of total charges were due to standard\u2010of\u2010care treatment for HNC: surgery ($16\u00a0million), radiation therapy ($22\u00a0million), or chemotherapy ($11\u00a0million). The median total charge per patient was $212,484 (interquartile range, $78,630\u2010$475,823). Multivariable regression demonstrated that the following were associated with increased charges: nasopharynx subsite ($250,929 [95% CI, $93,290\u2010$408,569]; effect size in US dollars, <jats:italic>P<\/jats:italic> =. 002), advanced stage (American Joint Committee on Cancer, seventh edition; $80,331 [$22,726\u2010$137,936], <jats:italic>P<\/jats:italic> =. 007), therapeutic surgery ($281,893 [$117,371\u2010$446,415], <jats:italic>P<\/jats:italic> =. 001), chemotherapy ($183,331 [$125,497\u2010$241,165], <jats:italic>P<\/jats:italic> &lt;. 001), radiation ($203,397 [$143,454\u2010$263,341], <jats:italic>P<\/jats:italic> &lt;. 001), surgical complication requiring return to the operating room ($147,247 [$37,240\u2010$257,254], <jats:italic>P<\/jats:italic> =. 009), emergency department visits ($89,050 [$23,811\u2010$154,289], <jats:italic>P<\/jats:italic> =. 008), and admissions ($140,894 [$82,895\u2010$198,893], <jats:italic>P<\/jats:italic> &lt;. 001; constant, \u2013$233,927 [\u2013$410,790 to \u2013$57,064]). The top quartile accrued 55% of the total charges.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Radiation, followed by surgery and chemotherapy, were the most expensive components of HNC care. In this analysis, we identified the dominant clinical factors associated with increased charges.<\/jats:p><\/jats:sec>","DOI":"10.1177\/0194599820921401","type":"journal-article","created":{"date-parts":[[2020,5,26]],"date-time":"2020-05-26T04:21:37Z","timestamp":1590466897000},"page":"546-553","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":6,"title":["An Analysis of 1\u2010Year Charges for Head and Neck Cancer: Targets for Value\u2010Based Interventions"],"prefix":"10.1002","volume":"163","author":[{"given":"John","family":"Pang","sequence":"first","affiliation":[{"name":"Division of Otolaryngology\u2013Head and Neck Surgery Department of Surgery School of Medicine University of California\u2013San Diego La Jolla CA USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kayva","family":"Crawford","sequence":"additional","affiliation":[{"name":"Division of Otolaryngology\u2013Head and Neck Surgery Department of Surgery School of Medicine University of California\u2013San Diego La Jolla CA USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Farhoud","family":"Faraji","sequence":"additional","affiliation":[{"name":"Division of Otolaryngology\u2013Head and Neck Surgery Department of Surgery School of Medicine University of California\u2013San Diego La Jolla CA USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Celia","family":"Ramsey","sequence":"additional","affiliation":[{"name":"Division of Otolaryngology\u2013Head and Neck Surgery Department of Surgery School of Medicine University of California\u2013San Diego La Jolla CA USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Aaron","family":"Kemp","sequence":"additional","affiliation":[{"name":"Division of Otolaryngology\u2013Head and Neck Surgery Department of Surgery School of Medicine University of California\u2013San Diego La Jolla CA USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"suffix":"III","given":"Joseph A.","family":"Califano","sequence":"additional","affiliation":[{"name":"Division of Otolaryngology\u2013Head and Neck Surgery Department of Surgery School of Medicine University of California\u2013San Diego La Jolla CA USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2020,5,26]]},"reference":[{"key":"e_1_2_9_2_1","doi-asserted-by":"publisher","DOI":"10.1002\/cncr.29808"},{"key":"e_1_2_9_3_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMhpr0807774"},{"key":"e_1_2_9_4_1","doi-asserted-by":"publisher","DOI":"10.1634\/theoncologist.2012-0279"},{"key":"e_1_2_9_5_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMp1508387"},{"key":"e_1_2_9_6_1","doi-asserted-by":"publisher","DOI":"10.1093\/jnci\/djq495"},{"key":"e_1_2_9_7_1","doi-asserted-by":"publisher","DOI":"10.1377\/hlthaff.2015.0830"},{"key":"e_1_2_9_8_1","doi-asserted-by":"publisher","DOI":"10.1001\/jamaoto.2018.3982"},{"key":"e_1_2_9_9_1","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0148076"},{"key":"e_1_2_9_10_1","doi-asserted-by":"publisher","DOI":"10.1016\/0895-4356(94)90129-5"},{"key":"e_1_2_9_11_1","doi-asserted-by":"publisher","DOI":"10.1016\/S1470-2045(17)30260-7"},{"key":"e_1_2_9_12_1","doi-asserted-by":"publisher","DOI":"10.1002\/lary.27544"},{"key":"e_1_2_9_13_1","doi-asserted-by":"publisher","DOI":"10.1093\/jnci\/djn175"},{"key":"e_1_2_9_14_1","doi-asserted-by":"publisher","DOI":"10.1200\/EDBK_200141"},{"key":"e_1_2_9_15_1","doi-asserted-by":"publisher","DOI":"10.1200\/JOP.2017.022905"},{"key":"e_1_2_9_16_1","doi-asserted-by":"publisher","DOI":"10.1177\/0269216317690098"},{"issue":"2","key":"e_1_2_9_17_1","first-page":"e59","article-title":"Variation in markups on outpatient oncology services in the United States","volume":"24","author":"Park A","year":"2018","journal-title":"Am J Manag Care"},{"key":"e_1_2_9_18_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.amjcard.2016.01.004"},{"key":"e_1_2_9_19_1","doi-asserted-by":"publisher","DOI":"10.1002\/hed.24988"},{"key":"e_1_2_9_20_1","doi-asserted-by":"publisher","DOI":"10.1001\/jamaoto.2016.2981"},{"key":"e_1_2_9_21_1","unstructured":"Public Policy Institute of California McConvilleS DanielsonC HsiaR.Emergency department use in California\u2014demographics trends and the impact of the ACA.https:\/\/www.ppic.org\/publication\/emergency\u2010department\u2010use\u2010in\u2010california\u2010demographics\u2010trends\u2010and\u2010the\u2010impact\u2010of\u2010the\u2010aca\/. 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