Direct cost variance analysis of peroral endoscopic myotomy

Achalasia Cost analysis Laparoscopic Heller myotomy Peroral endoscopic myotomy

Journal

World journal of gastrointestinal endoscopy
ISSN: 1948-5190
Titre abrégé: World J Gastrointest Endosc
Pays: United States
ID NLM: 101532474

Informations de publication

Date de publication:
16 Oct 2023
Historique:
received: 06 07 2023
revised: 23 08 2023
accepted: 11 09 2023
medline: 30 10 2023
pubmed: 30 10 2023
entrez: 30 10 2023
Statut: ppublish

Résumé

Laparoscopic Heller myotomy (LHM) has been the traditional surgical treatment for achalasia. Recently, peroral endoscopic myotomy (POEM) has demonstrated similar clinical outcomes with shorter procedure times. Studies comparing the direct cost-effectiveness of POEM To compare costs of POEM This retrospective chart review aimed to compare the outcomes and cost of clinical care between patients who underwent POEM and LHM procedures for achalasia. The study was conducted at a tertiary academic center from January 2019 to December 2020. Clinical outcomes, including post-operative Eckardt scores and adverse events, were assessed and compared between the two groups. Direct cost variance analysis was utilized to evaluate the cost of clinical care incurred by patients undergoing POEM in the year preceding the procedure, during the index admission, and one year post-procedure, in comparison to patients undergoing LHM. Of 30 patients were included (15 POEM and 15 LHM) in the study. Patients in the POEM group had a mean Eckardt score of 0.5 ± 0.5 post-procedure, which was no different from patients in the LHM group (0.7 ± 0.6, Despite similar clinical outcomes, the cost of the index procedure admission for POEM was significantly lower than for LHM. The difference was primarily related to shorter time increments utilized in the operating room during the index procedure, and shorter length of hospital stay following POEM.

Sections du résumé

BACKGROUND BACKGROUND
Laparoscopic Heller myotomy (LHM) has been the traditional surgical treatment for achalasia. Recently, peroral endoscopic myotomy (POEM) has demonstrated similar clinical outcomes with shorter procedure times. Studies comparing the direct cost-effectiveness of POEM
AIM OBJECTIVE
To compare costs of POEM
METHODS METHODS
This retrospective chart review aimed to compare the outcomes and cost of clinical care between patients who underwent POEM and LHM procedures for achalasia. The study was conducted at a tertiary academic center from January 2019 to December 2020. Clinical outcomes, including post-operative Eckardt scores and adverse events, were assessed and compared between the two groups. Direct cost variance analysis was utilized to evaluate the cost of clinical care incurred by patients undergoing POEM in the year preceding the procedure, during the index admission, and one year post-procedure, in comparison to patients undergoing LHM.
RESULTS RESULTS
Of 30 patients were included (15 POEM and 15 LHM) in the study. Patients in the POEM group had a mean Eckardt score of 0.5 ± 0.5 post-procedure, which was no different from patients in the LHM group (0.7 ± 0.6,
CONCLUSION CONCLUSIONS
Despite similar clinical outcomes, the cost of the index procedure admission for POEM was significantly lower than for LHM. The difference was primarily related to shorter time increments utilized in the operating room during the index procedure, and shorter length of hospital stay following POEM.

Identifiants

pubmed: 37900115
doi: 10.4253/wjge.v15.i10.593
pmc: PMC10600690
doi:

Types de publication

Journal Article

Langues

eng

Pagination

593-601

Informations de copyright

©The Author(s) 2023. Published by Baishideng Publishing Group Inc. All rights reserved.

Déclaration de conflit d'intérêts

Conflict-of-interest statement: All the authors report no relevant conflicts of interest for this article.

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Auteurs

Syedreza Ali Haider (SA)

Department of Internal Medicine, Washington University School of Medicine St. Louis, St. Louis, MO 63018, United States.

Gregory S Bills (GS)

Department of Digestive Disease and Nutrition, University of Kentucky College of Medicine, Lexington, KY 40508, United States.

C Prakash Gyawali (CP)

Department of Internal Medicine, Washington University School of Medicine St. Louis and Barnes Jewish Hospital, St. Louis, MO 63108, United States.

Passisd Laoveeravat (P)

Department of Digestive Disease and Nutrition, University of Kentucky College of Medicine, Lexington, KY 40508, United States.

Jordan Miller (J)

Department of Cardiothoracic Surgery, University of Kentucky College of Medicine, Lexington, KY 40508, United States.

Samir Softic (S)

Department of Pediatrics, University of Kentucky College of Medicine and Kentucky Children's Hospital, Lexington, KY 40508, United States.

Mihir S Wagh (MS)

Interventional Endoscopy, Division of Gastroenterology, University of Colorado School of Medicine, Aurora, CO 80045, United States.

Moamen Gabr (M)

Department of Advanced Endoscopy, Beth Israel Deaconess Medical Center, Boston, MA 02215, United States. mgabr@bidmc.harvard.edu.

Classifications MeSH