Economic Evaluation of Pediatric Tracheostomy: A Cost of Illness Analysis.

Autor: Zhang J; Department of Otolaryngology-Head and Neck Surgery University of Texas Southwestern Medical Center Dallas Texas USA., Liu P; Department of Otolaryngology-Head and Neck Surgery University of Texas Southwestern Medical Center Dallas Texas USA., Narayanan AM; Department of Otolaryngology-Head and Neck Surgery University of Texas Southwestern Medical Center Dallas Texas USA., Chorney SR; Department of Otolaryngology-Head and Neck Surgery University of Texas Southwestern Medical Center Dallas Texas USA.; Children's Health Airway Management Program Children's Medical Center Dallas Dallas Texas USA., Kou YF; Department of Otolaryngology-Head and Neck Surgery University of Texas Southwestern Medical Center Dallas Texas USA.; Children's Health Airway Management Program Children's Medical Center Dallas Dallas Texas USA., Johnson RF; Department of Otolaryngology-Head and Neck Surgery University of Texas Southwestern Medical Center Dallas Texas USA.; Children's Health Airway Management Program Children's Medical Center Dallas Dallas Texas USA.
Jazyk: angličtina
Zdroj: OTO open [OTO Open] 2024 Jan 17; Vol. 8 (1), pp. e108. Date of Electronic Publication: 2024 Jan 17 (Print Publication: 2024).
DOI: 10.1002/oto2.108
Abstrakt: Objective: This study aimed to determine the direct costs of pediatric tracheostomy care within a health care system.
Study Design: Prospective analysis.
Setting: Academic children's hospital.
Methods: Costs associated with caring for pediatric tracheostomy patients under 18 years were analyzed between 2015 and 2021. Direct costs were calculated using the Medicare/Medicaid charges-to-costs ratio for various visit types. Costs were estimated using generalized linear equations, accounting for confounders.
Results: A total of 297 children underwent tracheostomy at a median age of 0.94 years. The median follow-up was 2.5 years, resulting in 13,966 visits (mean = 41). The total cost was $321 million. The initial admission accounted for 72% ($231 million) of costs while other inpatient admissions added 24% ($78 million). Emergency department, observation, and outpatient visits comprised 4% of costs. The length of stay (LOS) was the primary cost driver for inpatient visits. Each additional hospital day increased costs by roughly $1195, and each extra admission added about $130,223 after adjusting for confounders. Respiratory failure and infections were the primary reasons for 67% of subsequent admissions.
Conclusion: Pediatric tracheostomy care generated over $300 million in direct costs over 5 years. Inpatient stays constituted 96% of these costs, with the LOS being a major factor. To reduce direct health expenditures for these patients, the focus should be on minimizing admissions.
Competing Interests: None.
(© 2024 The Authors. OTO Open published by Wiley Periodicals LLC on behalf of American Academy of Otolaryngology–Head and Neck Surgery Foundation.)
Databáze: MEDLINE
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