Dataset Information

Health Care Costs and Cost-effectiveness in Laryngotracheal Stenosis.

ABSTRACT: OBJECTIVE:Laryngotracheal stenosis (LTS) is resource-intensive disease. The cost-effectiveness of LTS treatments has not been adequately explored. We aimed to conduct a cost-effectiveness analysis comparing open reconstruction (cricotracheal/tracheal resection [CTR/TR]) with endoscopic dilation in the treatment of LTS. STUDY DESIGN:Retrospective cohort. SETTING:Tertiary referral center (2013-2017). SUBJECTS AND METHODS:Thirty-four LTS patients were recruited. Annual costs were derived from the Department of Otolaryngology-Head and Neck Surgery, Johns Hopkins University. Cost-effectiveness analysis compared CTR/TR versus endoscopic dilation at a willingness-to-pay threshold of $50,000 per quality-adjusted life year (QALY) over 5- and 10-year time horizons. The incremental cost-effectiveness ratio (ICER) was calculated with deterministic analysis and tested for sensitivity with univariate and probabilistic sensitivity analysis. RESULTS:Mean LTS costs were $4080.09 (SE, $569.29) annually for related health care visits. The major risk factor for increased cost was etiology of stenosis. As compared with idiopathic patients, patients with intubation-related stenosis had significantly higher annual costs ($5286.56 vs $2873.62, P = .03). The cost of CTR/TR was $8583.91 (SE, $2263.22). Over a 5-year time horizon, CTR/TR gained $896 per QALY over serial dilations and was cost-effective. Over a 10-year time horizon, CTR/TR dominated dilations with a lower cost and higher QALY. CONCLUSION:The cost of treatment for LTS is significant. Patients with intubation-related stenosis have significantly higher annual costs than do idiopathic patients. CTR/TR contributes significantly to cost in LTS but is cost-effective versus endoscopic dilations for appropriately selected patients over a 5- and 10-year horizon.

SUBMITTER: Yin LX

PROVIDER: S-EPMC6443425 | biostudies-literature | 2019 Apr

REPOSITORIES: biostudies-literature

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Health Care Costs and Cost-effectiveness in Laryngotracheal Stenosis.

Yin Linda X LX Padula William V WV Gadkaree Shekhar S Motz Kevin K Rahman Sabrina S Predmore Zachary Z Gelbard Alexander A Hillel Alexander T AT

Otolaryngology--head and neck surgery : official journal of American Academy of Otolaryngology-Head and Neck Surgery 20181127 4

<h4>Objective</h4>Laryngotracheal stenosis (LTS) is resource-intensive disease. The cost-effectiveness of LTS treatments has not been adequately explored. We aimed to conduct a cost-effectiveness analysis comparing open reconstruction (cricotracheal/tracheal resection [CTR/TR]) with endoscopic dilation in the treatment of LTS.<h4>Study design</h4>Retrospective cohort.<h4>Setting</h4>Tertiary referral center (2013-2017).<h4>Subjects and methods</h4>Thirty-four LTS patients were recruited. Annual ...[more]

PMID: 30481123

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Dataset Information

Health Care Costs and Cost-effectiveness in Laryngotracheal Stenosis.

Publications

Health Care Costs and Cost-effectiveness in Laryngotracheal Stenosis.

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