OBJECTIVES: To (1) identify the major expenses for same-day adenotonsillectomy (T&A) and the costs for postoperative complication encounters in a children's hospital and (2) compare differences for variations in costs by surgeon. STUDY DESIGN: Observational cohort study. SETTING: Tertiary children's hospital. SUBJECTS AND METHODS: A standardized activity-based hospital accounting system was used to determine total hospital costs per encounter (not including professional fees for surgeons or anesthetists) for T&A cases at a tertiary children's hospital from 2007 to 2012. Hospital costs were subdivided into categories, including operating room (OR), OR supplies, postanesthesia care unit (PACU), same-day services (SDS), anesthesia, pharmacy, and other. Costs for postoperative complication encounters were included to identify a mean total cost per case per surgeon. RESULTS: The study cohort included 4824 T&As performed by 14 different surgeons. The mean cost per T&A was $1506 (95% confidence interval, $1492-$1519, with a range of $1156-$1828 for the lowest and highest cost per case per surgeon; P < .01). Including the cost for postoperative complications, the mean cost increased to $1599 ($1570-$1629). The largest cost categories included OR (31.9%), SDS (28.1%), and OR supplies (15.6%). CONCLUSION: A large portion of T&A expenses are due to OR and supply costs. Significant differences in costs between surgeons for outpatient T&A were identified. Studies to understand the reasons for this variation and the impact on outcomes are needed. If this variation does not affect patient outcomes, then reducing this variation may improve health care value by limiting waste.
OBJECTIVES: To (1) identify the major expenses for same-day adenotonsillectomy (T&A) and the costs for postoperative complication encounters in a children's hospital and (2) compare differences for variations in costs by surgeon. STUDY DESIGN: Observational cohort study. SETTING: Tertiary children's hospital. SUBJECTS AND METHODS: A standardized activity-based hospital accounting system was used to determine total hospital costs per encounter (not including professional fees for surgeons or anesthetists) for T&A cases at a tertiary children's hospital from 2007 to 2012. Hospital costs were subdivided into categories, including operating room (OR), OR supplies, postanesthesia care unit (PACU), same-day services (SDS), anesthesia, pharmacy, and other. Costs for postoperative complication encounters were included to identify a mean total cost per case per surgeon. RESULTS: The study cohort included 4824 T&As performed by 14 different surgeons. The mean cost per T&A was $1506 (95% confidence interval, $1492-$1519, with a range of $1156-$1828 for the lowest and highest cost per case per surgeon; P < .01). Including the cost for postoperative complications, the mean cost increased to $1599 ($1570-$1629). The largest cost categories included OR (31.9%), SDS (28.1%), and OR supplies (15.6%). CONCLUSION: A large portion of T&A expenses are due to OR and supply costs. Significant differences in costs between surgeons for outpatient T&A were identified. Studies to understand the reasons for this variation and the impact on outcomes are needed. If this variation does not affect patient outcomes, then reducing this variation may improve health care value by limiting waste.
Authors: Michelle P Debbink; Torri D Metz; Richard E Nelson; Sophie E Janes; Alexandra Kroes; Lori J Begaye; Cara C Heuser; Marcela C Smid; Robert M Silver; Michael W Varner; Brett D Einerson Journal: Am J Perinatol Date: 2021-12-02 Impact factor: 3.079
Authors: Christopher P Childers; Susan L Ettner; Ron D Hays; Gerald Kominski; Melinda Maggard-Gibbons; Rodrigo F Alban Journal: Ann Surg Date: 2021-07-01 Impact factor: 13.787
Authors: Chen Lin; Arlyne K Thung; Kris R Jatana; Jennifer N Cooper; L Christine Barron; Charles A Elmaraghy Journal: Laryngoscope Investig Otolaryngol Date: 2018-11-28
Authors: Brett D Einerson; Richard E Nelson; Grecio Sandoval; M Sean Esplin; D Ware Branch; Torri D Metz; Robert M Silver; William A Grobman; Uma M Reddy; Michael Varner Journal: Obstet Gynecol Date: 2020-07 Impact factor: 7.623