Details
| Original language | English |
|---|---|
| Journal | European Journal of Pediatric Surgery |
| Early online date | 29 Oct 2024 |
| Publication status | E-pub ahead of print - 29 Oct 2024 |
Abstract
Background Esophageal atresia (EA) is a rare disease requiring surgical repair, usually within the first days of life. Patients with EA require intensive postoperative care and often have comorbidities. There is a lack of data on the costs incurred by patients with EA during the first year of life. Methods Anonymized claims data were provided by the Techniker Krankenkasse (~10.8 million clients). Data were extracted for patients who had an inpatient diagnosis of EA (International Classification of Diseases [ICD]: Q39.0 or Q39.1) and a reconstruction of the esophageal passage in case of atresia (Operationen-und Prozedurenschlüssel [German version of ICPM, International Classification of Procedures in Medicine; OPS] 5–428.0 to 5–428.7, 5–316.1 or 5–431.0) during their first hospital stay. All patients were in their first year of life at initial hospitalization (2016–2020) and were followed up for 1 year. Costs, length of hospital stay, and duration of mechanical ventilation and differentiated OPS services were analyzed using descriptive statistics. Multiple linear regression was used to analyze the determinants of hospital costs. Results A total of 119 patients with EA were included (55.5% male). The mean cost of the 1-year observation period was €89,736 ± 97,419 (range €12,755–640,154). The increasing costs of the initial hospitalization led to a disproportionate increase in the costs of the 1-year observation period. The presence of an associated malformation combined with surgical complications was associated with almost five-fold higher costs than in patients without an associated malformation and an uncomplicated course (€193,103 ± 157,507 vs. €39,846 ± 33,473). The mean duration of mechanical ventilation was 23.2 ± 43.1 days and the mean length of hospital stay was 80.3 ± 77.2 days. Conclusion To our knowledge, this is the first study to investigate the costs of EA patients in the first year of life. The presence of an associated malformation combined with surgical complications was associated with almost five-fold higher costs than in patients without an associated malformation and an uncomplicated course.
Keywords
- congenital malformations, economic, esophageal atresia, pediatric, surgical complications
ASJC Scopus subject areas
- Medicine(all)
- Pediatrics, Perinatology, and Child Health
- Medicine(all)
- Surgery
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In: European Journal of Pediatric Surgery, 29.10.2024.
Research output: Contribution to journal › Article › Research › peer review
}
TY - JOUR
T1 - Medical Costs of Patients Undergoing Esophageal Atresia Repair are Mainly Influenced by Associated Malformations
AU - Pardey, Nicolas
AU - Zeidler, Jan
AU - Blaser, Jochen
AU - Becker, Nastassja
AU - Dingemann, Jens
AU - Ure, Benno
AU - Schukfeh, Nagoud
N1 - Publisher Copyright: © 2024. Thieme. All rights reserved.
PY - 2024/10/29
Y1 - 2024/10/29
N2 - Background Esophageal atresia (EA) is a rare disease requiring surgical repair, usually within the first days of life. Patients with EA require intensive postoperative care and often have comorbidities. There is a lack of data on the costs incurred by patients with EA during the first year of life. Methods Anonymized claims data were provided by the Techniker Krankenkasse (~10.8 million clients). Data were extracted for patients who had an inpatient diagnosis of EA (International Classification of Diseases [ICD]: Q39.0 or Q39.1) and a reconstruction of the esophageal passage in case of atresia (Operationen-und Prozedurenschlüssel [German version of ICPM, International Classification of Procedures in Medicine; OPS] 5–428.0 to 5–428.7, 5–316.1 or 5–431.0) during their first hospital stay. All patients were in their first year of life at initial hospitalization (2016–2020) and were followed up for 1 year. Costs, length of hospital stay, and duration of mechanical ventilation and differentiated OPS services were analyzed using descriptive statistics. Multiple linear regression was used to analyze the determinants of hospital costs. Results A total of 119 patients with EA were included (55.5% male). The mean cost of the 1-year observation period was €89,736 ± 97,419 (range €12,755–640,154). The increasing costs of the initial hospitalization led to a disproportionate increase in the costs of the 1-year observation period. The presence of an associated malformation combined with surgical complications was associated with almost five-fold higher costs than in patients without an associated malformation and an uncomplicated course (€193,103 ± 157,507 vs. €39,846 ± 33,473). The mean duration of mechanical ventilation was 23.2 ± 43.1 days and the mean length of hospital stay was 80.3 ± 77.2 days. Conclusion To our knowledge, this is the first study to investigate the costs of EA patients in the first year of life. The presence of an associated malformation combined with surgical complications was associated with almost five-fold higher costs than in patients without an associated malformation and an uncomplicated course.
AB - Background Esophageal atresia (EA) is a rare disease requiring surgical repair, usually within the first days of life. Patients with EA require intensive postoperative care and often have comorbidities. There is a lack of data on the costs incurred by patients with EA during the first year of life. Methods Anonymized claims data were provided by the Techniker Krankenkasse (~10.8 million clients). Data were extracted for patients who had an inpatient diagnosis of EA (International Classification of Diseases [ICD]: Q39.0 or Q39.1) and a reconstruction of the esophageal passage in case of atresia (Operationen-und Prozedurenschlüssel [German version of ICPM, International Classification of Procedures in Medicine; OPS] 5–428.0 to 5–428.7, 5–316.1 or 5–431.0) during their first hospital stay. All patients were in their first year of life at initial hospitalization (2016–2020) and were followed up for 1 year. Costs, length of hospital stay, and duration of mechanical ventilation and differentiated OPS services were analyzed using descriptive statistics. Multiple linear regression was used to analyze the determinants of hospital costs. Results A total of 119 patients with EA were included (55.5% male). The mean cost of the 1-year observation period was €89,736 ± 97,419 (range €12,755–640,154). The increasing costs of the initial hospitalization led to a disproportionate increase in the costs of the 1-year observation period. The presence of an associated malformation combined with surgical complications was associated with almost five-fold higher costs than in patients without an associated malformation and an uncomplicated course (€193,103 ± 157,507 vs. €39,846 ± 33,473). The mean duration of mechanical ventilation was 23.2 ± 43.1 days and the mean length of hospital stay was 80.3 ± 77.2 days. Conclusion To our knowledge, this is the first study to investigate the costs of EA patients in the first year of life. The presence of an associated malformation combined with surgical complications was associated with almost five-fold higher costs than in patients without an associated malformation and an uncomplicated course.
KW - congenital malformations
KW - economic
KW - esophageal atresia
KW - pediatric
KW - surgical complications
UR - http://www.scopus.com/inward/record.url?scp=85209091617&partnerID=8YFLogxK
U2 - 10.1055/a-2422-3247
DO - 10.1055/a-2422-3247
M3 - Article
C2 - 39322202
AN - SCOPUS:85209091617
JO - European Journal of Pediatric Surgery
JF - European Journal of Pediatric Surgery
SN - 0939-7248
ER -