1531-4995/asset/olalertbanner.jpg?v=1&s=9ff3f490af314cd21d170f4a5c82f3bd34d13f4a)
Objectives/Hypothesis
1) Identify the major expenses for outpatient pediatric tympanostomy tube placement in a multihospital network. 2) Compare differences for variations in costs among hospitals and surgeons.
The Laryngoscope
Explore this journal >
Pediatrics
Variation in costs among surgeons and hospitals in Pediatric tympanostomy tube placement
-
Presented at the Triological Society 118th Annual Meeting at the Combined Sections Meeting in Boston, Massachusetts, U.S.A, April 24–25, 2015.
-
Dr. Jeremy D. Meier received a Triological Society Career Development Award unrelated to this research. Dr. Rajendu Srivastava chairs the Pediatric Research in Inpatient Settings with several federally funded grants, none of which are related to this research. The authors have no other funding, financial relationships, or conflicts of interest to disclose.
Abstract
Methods
An observational cohort study in a multihospital network using a standardized activity-based accounting system to determine hospital costs for tympanostomy tube placement from February 2011 to January 2015. Children aged 6 months to less than 3 years old who underwent same-day surgery (SDS) for tympanostomy tubes at 15 hospital facilities were included. Subjects with additional procedures were excluded. Hospital costs were subdivided into categories including operating room (OR), SDS preoperative, SDS postoperative, postanesthesia care unit, anesthesia, pharmacy, and OR supplies.
Results
The study cohort included 5,623 patients undergoing tympanostomy tube placement by 67 surgeons. Mean cost per surgery was $769 ± $3. Significant variations (P < 0.001) in mean cost per procedure were identified by hospital (range $1212 ± $38 to $509 ± $11) and by surgeon (range $1330 ± $75 to $660 ± $11). Operating room and SDS preoperative were the greatest expenditures; each category accounted for over 30% of overall costs. Pharmacy costs and OR costs were some of the major drivers of cost variation among surgeons.
Conclusion
This study demonstrates that OR and SDS preoperative costs accounted for the greatest expenditure in tympanostomy tube placement, and significant variation exists among surgeons and hospitals within a multihospital network. Further research is needed to elucidate factors accounting for such variation in cost and the overall impact on patient outcomes.
Level of Evidence
4. Laryngoscope, 126:1935–1939, 2016