Ryan H Belcher, Kalpana Patel, Steven Goudy, Alexander Gelbard, L Dupree Hatch, Emily A Morris, Michael Golinko, James D Phillips, Andrew Scott
{"title":"对接受下颌牵引术的罗宾序列新生儿避免使用胃造瘘管的成本分析。","authors":"Ryan H Belcher, Kalpana Patel, Steven Goudy, Alexander Gelbard, L Dupree Hatch, Emily A Morris, Michael Golinko, James D Phillips, Andrew Scott","doi":"10.1002/lary.31810","DOIUrl":null,"url":null,"abstract":"<p><strong>Objectives/hypothesis: </strong>To evaluate costs associated with perioperative gastrostomy tube (G-tube) placement for neonates with Robin sequence (PRS) that undergo mandibular distraction osteogenesis (MDO).</p><p><strong>Methods: </strong>Retrospective chart review was performed to examine the medical records of neonates with RS who received treatment at our institution between 2012 and 2021. Patients under 6 months of age that underwent MDO for RS were included. Billing records of hospital costs over a 2-year period were analyzed.</p><p><strong>Results: </strong>The study included 26 total patients with 11 in the MDO-only group, 9 in G-tube after MDO group, and 6 in G-tube before MDO group. There was a significant difference (p < 0.001) in total hospital costs between groups with MDO-only group averaging $119,532 (SD <math> <semantics><mrow><mo>±</mo></mrow> <annotation>$$ \\pm $$</annotation></semantics> </math> 33,503), the G-tube after MDO group averaging $245,315 (SD <math> <semantics><mrow><mo>±</mo></mrow> <annotation>$$ \\pm $$</annotation></semantics> </math> 102,327), and G-tube before MDO group averaging $252,300 (SD <math> <semantics><mrow><mo>±</mo></mrow> <annotation>$$ \\pm $$</annotation></semantics> </math> 84,990). Multiple linear regression was performed controlling for genetic syndrome and birth weight, which still showed a statistically significant difference in total cost between the MDO-only group and G-tube after MDO (p = 0.006), and between the MDO-only group and G-tube prior to MDO (p = 0.01). There was a significant difference in costs between all three groups for total inpatient/outpatient costs with MDO-only group averaging $78,502 (SD <math> <semantics><mrow><mo>±</mo></mrow> <annotation>$$ \\pm $$</annotation></semantics> </math> 30,953), the G-tube after MDO group averaging $176,125 (SD <math> <semantics><mrow><mo>±</mo></mrow> <annotation>$$ \\pm $$</annotation></semantics> </math> 84,315), and the G-tube prior to MDO group averaging $156,309 (SD <math> <semantics><mrow><mo>±</mo></mrow> <annotation>$$ \\pm $$</annotation></semantics> </math> 95,746).</p><p><strong>Conclusions: </strong>MDO performed without perioperative G-tube placement may reduce charges by >$100,000. The associated improvement of dysphagia after MDO surgery and potential for avoiding a G-tube has tremendous downstream cost and social benefits for families.</p><p><strong>Level of evidence: </strong>NA Laryngoscope, 2024.</p>","PeriodicalId":49921,"journal":{"name":"Laryngoscope","volume":null,"pages":null},"PeriodicalIF":2.2000,"publicationDate":"2024-10-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Cost Analysis of Avoiding Gastrostomy Tube in Robin Sequence Neonates that Undergo Mandibular Distraction.\",\"authors\":\"Ryan H Belcher, Kalpana Patel, Steven Goudy, Alexander Gelbard, L Dupree Hatch, Emily A Morris, Michael Golinko, James D Phillips, Andrew Scott\",\"doi\":\"10.1002/lary.31810\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Objectives/hypothesis: </strong>To evaluate costs associated with perioperative gastrostomy tube (G-tube) placement for neonates with Robin sequence (PRS) that undergo mandibular distraction osteogenesis (MDO).</p><p><strong>Methods: </strong>Retrospective chart review was performed to examine the medical records of neonates with RS who received treatment at our institution between 2012 and 2021. Patients under 6 months of age that underwent MDO for RS were included. Billing records of hospital costs over a 2-year period were analyzed.</p><p><strong>Results: </strong>The study included 26 total patients with 11 in the MDO-only group, 9 in G-tube after MDO group, and 6 in G-tube before MDO group. There was a significant difference (p < 0.001) in total hospital costs between groups with MDO-only group averaging $119,532 (SD <math> <semantics><mrow><mo>±</mo></mrow> <annotation>$$ \\\\pm $$</annotation></semantics> </math> 33,503), the G-tube after MDO group averaging $245,315 (SD <math> <semantics><mrow><mo>±</mo></mrow> <annotation>$$ \\\\pm $$</annotation></semantics> </math> 102,327), and G-tube before MDO group averaging $252,300 (SD <math> <semantics><mrow><mo>±</mo></mrow> <annotation>$$ \\\\pm $$</annotation></semantics> </math> 84,990). Multiple linear regression was performed controlling for genetic syndrome and birth weight, which still showed a statistically significant difference in total cost between the MDO-only group and G-tube after MDO (p = 0.006), and between the MDO-only group and G-tube prior to MDO (p = 0.01). There was a significant difference in costs between all three groups for total inpatient/outpatient costs with MDO-only group averaging $78,502 (SD <math> <semantics><mrow><mo>±</mo></mrow> <annotation>$$ \\\\pm $$</annotation></semantics> </math> 30,953), the G-tube after MDO group averaging $176,125 (SD <math> <semantics><mrow><mo>±</mo></mrow> <annotation>$$ \\\\pm $$</annotation></semantics> </math> 84,315), and the G-tube prior to MDO group averaging $156,309 (SD <math> <semantics><mrow><mo>±</mo></mrow> <annotation>$$ \\\\pm $$</annotation></semantics> </math> 95,746).</p><p><strong>Conclusions: </strong>MDO performed without perioperative G-tube placement may reduce charges by >$100,000. The associated improvement of dysphagia after MDO surgery and potential for avoiding a G-tube has tremendous downstream cost and social benefits for families.</p><p><strong>Level of evidence: </strong>NA Laryngoscope, 2024.</p>\",\"PeriodicalId\":49921,\"journal\":{\"name\":\"Laryngoscope\",\"volume\":null,\"pages\":null},\"PeriodicalIF\":2.2000,\"publicationDate\":\"2024-10-03\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Laryngoscope\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.1002/lary.31810\",\"RegionNum\":3,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q3\",\"JCRName\":\"MEDICINE, RESEARCH & EXPERIMENTAL\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Laryngoscope","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1002/lary.31810","RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q3","JCRName":"MEDICINE, RESEARCH & EXPERIMENTAL","Score":null,"Total":0}
Cost Analysis of Avoiding Gastrostomy Tube in Robin Sequence Neonates that Undergo Mandibular Distraction.
Objectives/hypothesis: To evaluate costs associated with perioperative gastrostomy tube (G-tube) placement for neonates with Robin sequence (PRS) that undergo mandibular distraction osteogenesis (MDO).
Methods: Retrospective chart review was performed to examine the medical records of neonates with RS who received treatment at our institution between 2012 and 2021. Patients under 6 months of age that underwent MDO for RS were included. Billing records of hospital costs over a 2-year period were analyzed.
Results: The study included 26 total patients with 11 in the MDO-only group, 9 in G-tube after MDO group, and 6 in G-tube before MDO group. There was a significant difference (p < 0.001) in total hospital costs between groups with MDO-only group averaging $119,532 (SD 33,503), the G-tube after MDO group averaging $245,315 (SD 102,327), and G-tube before MDO group averaging $252,300 (SD 84,990). Multiple linear regression was performed controlling for genetic syndrome and birth weight, which still showed a statistically significant difference in total cost between the MDO-only group and G-tube after MDO (p = 0.006), and between the MDO-only group and G-tube prior to MDO (p = 0.01). There was a significant difference in costs between all three groups for total inpatient/outpatient costs with MDO-only group averaging $78,502 (SD 30,953), the G-tube after MDO group averaging $176,125 (SD 84,315), and the G-tube prior to MDO group averaging $156,309 (SD 95,746).
Conclusions: MDO performed without perioperative G-tube placement may reduce charges by >$100,000. The associated improvement of dysphagia after MDO surgery and potential for avoiding a G-tube has tremendous downstream cost and social benefits for families.
期刊介绍：
The Laryngoscope has been the leading source of information on advances in the diagnosis and treatment of head and neck disorders since 1890. The Laryngoscope is the first choice among otolaryngologists for publication of their important findings and techniques. Each monthly issue of The Laryngoscope features peer-reviewed medical, clinical, and research contributions in general otolaryngology, allergy/rhinology, otology/neurotology, laryngology/bronchoesophagology, head and neck surgery, sleep medicine, pediatric otolaryngology, facial plastics and reconstructive surgery, oncology, and communicative disorders. Contributions include papers and posters presented at the Annual and Section Meetings of the Triological Society, as well as independent papers, "How I Do It", "Triological Best Practice" articles, and contemporary reviews. Theses authored by the Triological Society’s new Fellows as well as papers presented at meetings of the American Laryngological Association are published in The Laryngoscope.
• Broncho-esophagology
• Communicative disorders
• Head and neck surgery
• Plastic and reconstructive facial surgery
• Oncology
• Speech and hearing defects
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