(1246) Nationwide Analysis of Hospital-Level Variations in Balloon Sinuplasty Rates

Introduction: Balloon sinuplasty (BSP) is an increasingly utilized procedure used to treat chronic rhinosinusitis (CRS), yet limited data exists regarding differences in utilization and outcomes between safety-net (SN) and non-safety net hospitals (non-SNHs). This retrospective cohort study examined BSP utilization and readmission rates between SN and non-SNHs.

Methods: Using the 2020 National Readmission Database (NRD), adult patients undergoing BSP were identified by ICD-10 procedural codes. Patient demographics, utilization rates by sinusitis subtype, 30-day readmission rates, complications, length of stay (LOS), and hospital charges were compared between SN and non–SNHs. Multivariable logistic regression was used to evaluate factors associated with BSP utilization and readmission.

Results: Among 4,857 patients, the 30-day readmission rate following BSP was 4.6%, most commonly due to infection (28.2%), bleeding or hematoma (22.0%), and pain-related complications (18.4%). BSP utilization was significantly higher at SNHs across all sinusitis subtypes, including pansinusitis (7.8 vs 5.1 per 100 procedures), maxillary (7.2 vs 4.8), frontal (6.9 vs 4.6), and ethmoidal sinusitis (6.5 vs 3.9) (all p < 0.05). After adjustment for age, sex, and insurance status, treatment at SNHs remained independently associated with higher BSP utilization (adjusted OR 1.42, 95% CI 1.21–1.67, p < 0.001).

Conclusions: BSP is associated with low 30-day readmission rates nationally. SNHs had higher utilization rates of BSP, and readmission rates among SNHs were comparable to their non-SN counterparts. These findings highlight the consistency in patient outcomes following BSP in diverse hospital settings while also demonstrating the financial burden of readmissions, emphasizing the importance of strategies to prevent preventable post-operative complications.