TY - JOUR
T1 - Tracheostomy versus mandibular distraction osteogenesis in infants with Robin sequence: A comparative cost analysis
AU - Paes, Emma C.
AU - Fouché, James J.
AU - Muradin, Marvick S. M.
AU - Speleman, Lucienne
AU - Kon, Moshe
AU - Breugem, Corstiaan C.
PY - 2014
Y1 - 2014
N2 - Many treatments have been described for infants with Robin sequence and severe respiratory distress, but there have not been many comparative studies of outcome and cost-effectiveness. The aim of this study was to compare the cost and complications of two common interventions - mandibular distraction osteogenesis and tracheostomy. Nine patients with isolated Robin sequence (mandibular distraction osteogenesis, n = 5, and tracheostomy, n = 4) were included in the analyses. Predetermined costs and complications were obtained retrospectively from medical records and by questionnaires to the parents over a 12-month period. Overall direct costs (admission to hospital, diagnostics, surgery, and homecare) were 3 times higher for tracheostomy (€105.523 compared with €33.482, p = 0.02). Overall indirect costs (absence from work) were almost 5 times higher (€2.543 compared with €543, p = 0.02). There was a threefold increase in overall total cost/patient (both direct and indirect) for tracheostomy (€108.057 compared with 34.016, p = 0.02) and 4 times more complications were encountered. This study shows that mandibular distraction osteogenesis in infants diagnosed with Robin sequence costs significantly less and results in fewer complications than tracheostomy, and this contributes to our current knowledge about the ideal approach for infants with Robin sequence and might provide a basis for institutional protocols in the future. © 2013 The British Association of Oral and Maxillofacial Surgeons.
AB - Many treatments have been described for infants with Robin sequence and severe respiratory distress, but there have not been many comparative studies of outcome and cost-effectiveness. The aim of this study was to compare the cost and complications of two common interventions - mandibular distraction osteogenesis and tracheostomy. Nine patients with isolated Robin sequence (mandibular distraction osteogenesis, n = 5, and tracheostomy, n = 4) were included in the analyses. Predetermined costs and complications were obtained retrospectively from medical records and by questionnaires to the parents over a 12-month period. Overall direct costs (admission to hospital, diagnostics, surgery, and homecare) were 3 times higher for tracheostomy (€105.523 compared with €33.482, p = 0.02). Overall indirect costs (absence from work) were almost 5 times higher (€2.543 compared with €543, p = 0.02). There was a threefold increase in overall total cost/patient (both direct and indirect) for tracheostomy (€108.057 compared with 34.016, p = 0.02) and 4 times more complications were encountered. This study shows that mandibular distraction osteogenesis in infants diagnosed with Robin sequence costs significantly less and results in fewer complications than tracheostomy, and this contributes to our current knowledge about the ideal approach for infants with Robin sequence and might provide a basis for institutional protocols in the future. © 2013 The British Association of Oral and Maxillofacial Surgeons.
UR - https://www.scopus.com/inward/record.uri?partnerID=HzOxMe3b&scp=84894081056&origin=inward
UR - https://www.ncbi.nlm.nih.gov/pubmed/24388657
U2 - https://doi.org/10.1016/j.bjoms.2013.11.017
DO - https://doi.org/10.1016/j.bjoms.2013.11.017
M3 - Article
C2 - 24388657
SN - 0266-4356
VL - 52
SP - 223
EP - 229
JO - British Journal of Oral & Maxillofacial Surgery
JF - British Journal of Oral & Maxillofacial Surgery
IS - 3
ER -