Evaluation of Intraoperative Testing During Cochlear Implantation From a Time and Cost Perspective: A Single-Center Experience in the United States
| Autor: | Fida Almuhawas, John L. Dornhoffer, Saleema A. Karim, Matthew D. Cox, Joshua Cody Page, Tristan Allsopp |
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| Rok vydání: | 2018 |
| Předmět: |
Male
medicine.medical_specialty Adolescent Operative Time Audiologist Tertiary referral hospital Single Center 03 medical and health sciences Intraoperative Period 0302 clinical medicine Audiometry Electric Impedance Medicine Humans Prospective Studies Hospital Costs 030223 otorhinolaryngology Prospective cohort study Cochlear implantation Child Evoked Potentials medicine.diagnostic_test business.industry Infant Cochlear Implantation Sensory Systems Single surgeon United States Cochlear Implants Treatment Outcome Otorhinolaryngology Child Preschool Emergency medicine Costs and Cost Analysis Female Neurology (clinical) business 030217 neurology & neurosurgery |
| Zdroj: | Otologyneurotology : official publication of the American Otological Society, American Neurotology Society [and] European Academy of Otology and Neurotology. 39(7) |
| ISSN: | 1537-4505 |
| Popis: | Objective To measure the time spent performing intraoperative testing during cochlear implantation (CI) and determine the impact on hospital charges. Study design Prospective study. Setting Tertiary referral hospital. Patients Twenty-two children (7 mo-18 yr) who underwent a total of 22 consecutive primary and/or revision CIs by a single surgeon from December 2016 to July 2017. Intervention The time spent performing intraoperative testing, including evoked compound action potentials (ECAP) and electrical impedances (EI), was recorded for each case. The audiologist performing the testing was unaware of the time measurement and subsequent evaluations with regard to cost data. Billing information was used to determine if the testing contributed to increased operative charges to the patient. Outcome measures Whether intraoperative testing had an impact on operative charges to the patient. Results The average time spent in testing (ECAPs/EIs in all cases) was 6.7 minutes (range, 2-26 min). No correlation was found between testing time and preoperative computed tomography findings, the audiologist performing testing, or the electrode type used (p > 0.05). Based on billing data, including time spent in the operating room (OR), 5/22 (23%) cases incurred greater charges than if intraoperative testing had not been performed. Conclusion Our data suggest that intraoperative testing increases time in the OR and can contribute to increased hospital charges for CI patients. By using testing selectively, costs incurred by patients and hospitals may be reduced. This is of interest in a healthcare environment that is increasingly focused on cost, quality, and outcomes. |
| Databáze: | OpenAIRE |
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