Simultaneous versus sequential bilateral cochlear implants in adults: Cost analysis in a US setting
| Autor: | Sarah W. Kennett, Aaron Trinidade, Matthew D. Cox, John L. Dornhoffer, Joshua Cody Page |
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| Rok vydání: | 2017 |
| Předmět: |
medicine.medical_specialty
business.industry 030503 health policy & services medicine.medical_treatment Evidence-based medicine Patient management Surgery 03 medical and health sciences Indirect costs 0302 clinical medicine Otorhinolaryngology Cochlear implant medicine Cost analysis Health insurance Implant 030223 otorhinolaryngology 0305 other medical science business Cochlear implantation |
| Zdroj: | The Laryngoscope. 127:2615-2618 |
| ISSN: | 0023-852X |
| Popis: | Objectives/Hypothesis From a purely surgical efficiency point of view, simultaneous cochlear implantation (SimCI) is more cost-effective than sequential cochlear implantation (SeqCI) when total direct costs are considered (implant and hospital costs). However, in a setting where only SeqCI is practiced and a proportion of initially unilaterally implanted patients do not progress to a second implant, this may not be the case, especially when audiological costs are factored in. We present a cost analysis of such a scenario as would occur in our institution. Study Design Retrospective review and cost analysis. Methods Between 2005 and 2015, 370 patients fulfilled the audiological criteria for bilateral implantation. Of those, 267 (72.1%) underwent unilateral cochlear implantation only, 101 (27.3%) progressed to SeqCI, and two underwent SimCI. The total hospital, surgical, and implant costs, and initial implant stimulation series audiological costs between August 2015 and August 2016 (29 adult patients) were used in this analysis. Results The total hospital, surgical, and implant costs for this period was $2,731,360.42. Based on previous local trends, if a projected eight (27.3%) of these patients decide to progress to SeqCI, this will cost an additional $750,811.04, resulting in an overall total of $3,482,171.46 for these 29 patients. Had all 29 undergone SimCI, the total projected cost would have been $3,332,991.75, representing a total potential saving of $149,179.67 (4.3%). Conclusions In institutions where only SeqCI is allowed in adults, overall patient management may cost marginally more than if SimCI were practiced. This will be of interest to CI programs and health insurance companies. Level of Evidence 4. Laryngoscope, 127:2615–2618, 2017 |
| Databáze: | OpenAIRE |
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