Cost savings for single event multilevel surgery in comparison to sequential surgery in ambulatory children with cerebral palsy.

Autor: Õunpuu S; Center for Motion Analysis, Connecticut Children's Medical Center, Farmington, CT, USA. Electronic address: sounpuu@connecticutchildrens.org., Pierz K; Center for Motion Analysis, Connecticut Children's Medical Center, Farmington, CT, USA., Rethlefsen SA; Children's Orthopaedic Center, Children's Hospital Los Angeles, Los Angeles, CA, USA., Wren TAL; Children's Orthopaedic Center, Children's Hospital Los Angeles, Los Angeles, CA, USA.
Jazyk: angličtina
Zdroj: Gait & posture [Gait Posture] 2022 Jul; Vol. 96, pp. 53-59. Date of Electronic Publication: 2022 May 07.
DOI: 10.1016/j.gaitpost.2022.05.005
Abstrakt: Background: The purpose of this study was to determine the differences in billable provider charges between single event multilevel surgery (SEMLS) based on comprehensive gait analysis and a staged surgical approach (SSA) without comprehensive gait analysis for the orthopedic treatment of ambulatory children with cerebral palsy (CP).
Methods: The charges associated with nine common orthopedic surgical combinations (both unilateral and bilateral, soft tissue or soft tissue plus bony) for children with CP were determined and compared between SEMLS and SSA. The charges included surgical, anesthesia, operating room, recovery room, hospital stay, physical therapy, and, for SEMLS only, comprehensive computerized gait analysis.
Results: Total charges to complete each combination was higher for SSA than for SEMLS. The differential ranged from $10,247 to $75,069 with the percentage difference ranging from 20% to 47%. The mean difference was $43,606 (p = 0.0002). The dollar difference (r = 0.98, p < 0.0001) and percentage difference (r = 0.79, p = 0.01) were both related to the total charge of the SEMLS surgery.
Significance: Financial costs are lower for SEMLS vs. SSA for the treatment of multilevel gait issues in children with CP. The cost of gait analysis is much smaller than the cost differential between SEMLS and SSA. Although some patients who have SEMLS may need additional orthopedic surgery with associated costs, this is also possible for SSA. Therefore, due to the many benefits of SEMLS, which also include more informed treatment decision-making as well as reduced time away from school and work (for caregivers), SEMLS guided by gait analysis is recommended over SSA for the treatment of gait disorders in children with CP.
(Copyright © 2022 Elsevier B.V. All rights reserved.)
Databáze: MEDLINE
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