Economic Evaluation of Pediatric Tracheostomy: A Cost of Illness Analysis
Abstract 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 ana...
| Main Authors: | , , , , , |
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| Format: | Article |
| Language: | English |
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Wiley
2024-01-01
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| Series: | OTO Open |
| Subjects: | |
| Online Access: | https://doi.org/10.1002/oto2.108 |
| _version_ | 1797223037874995200 |
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| author | Jinghan Zhang Palmila Liu Ajay M. Narayanan Stephen R. Chorney Yann‐Fuu Kou Romaine F. Johnson |
| author_facet | Jinghan Zhang Palmila Liu Ajay M. Narayanan Stephen R. Chorney Yann‐Fuu Kou Romaine F. Johnson |
| author_sort | Jinghan Zhang |
| collection | DOAJ |
| description | Abstract 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. |
| first_indexed | 2024-04-24T13:30:52Z |
| format | Article |
| id | doaj.art-5c0e0477e31c4a559feb4f1bfa3f1709 |
| institution | Directory Open Access Journal |
| issn | 2473-974X |
| language | English |
| last_indexed | 2024-04-24T13:30:52Z |
| publishDate | 2024-01-01 |
| publisher | Wiley |
| record_format | Article |
| series | OTO Open |
| spelling | doaj.art-5c0e0477e31c4a559feb4f1bfa3f17092024-04-04T09:30:28ZengWileyOTO Open2473-974X2024-01-0181n/an/a10.1002/oto2.108Economic Evaluation of Pediatric Tracheostomy: A Cost of Illness AnalysisJinghan Zhang0Palmila Liu1Ajay M. Narayanan2Stephen R. Chorney3Yann‐Fuu Kou4Romaine F. Johnson5Department of Otolaryngology–Head and Neck Surgery University of Texas Southwestern Medical Center Dallas Texas USADepartment of Otolaryngology–Head and Neck Surgery University of Texas Southwestern Medical Center Dallas Texas USADepartment of Otolaryngology–Head and Neck Surgery University of Texas Southwestern Medical Center Dallas Texas USADepartment of Otolaryngology–Head and Neck Surgery University of Texas Southwestern Medical Center Dallas Texas USADepartment of Otolaryngology–Head and Neck Surgery University of Texas Southwestern Medical Center Dallas Texas USADepartment of Otolaryngology–Head and Neck Surgery University of Texas Southwestern Medical Center Dallas Texas USAAbstract 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.https://doi.org/10.1002/oto2.108cost of illnesseconomic analysispediatric tracheostomy |
| spellingShingle | Jinghan Zhang Palmila Liu Ajay M. Narayanan Stephen R. Chorney Yann‐Fuu Kou Romaine F. Johnson Economic Evaluation of Pediatric Tracheostomy: A Cost of Illness Analysis OTO Open cost of illness economic analysis pediatric tracheostomy |
| title | Economic Evaluation of Pediatric Tracheostomy: A Cost of Illness Analysis |
| title_full | Economic Evaluation of Pediatric Tracheostomy: A Cost of Illness Analysis |
| title_fullStr | Economic Evaluation of Pediatric Tracheostomy: A Cost of Illness Analysis |
| title_full_unstemmed | Economic Evaluation of Pediatric Tracheostomy: A Cost of Illness Analysis |
| title_short | Economic Evaluation of Pediatric Tracheostomy: A Cost of Illness Analysis |
| title_sort | economic evaluation of pediatric tracheostomy a cost of illness analysis |
| topic | cost of illness economic analysis pediatric tracheostomy |
| url | https://doi.org/10.1002/oto2.108 |
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