Potential for health care cost savings with preoperative gastrostomy tube placement in the head and neck cancer population

Background The purpose of this study was to examine the cost differences between preoperative and postoperative placement of gastrostomy tubes (G‐tubes) in patients with head and neck cancer. Methods We conducted a retrospective chart review of patients with aerodigestive tract cancers from 2010 to...

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Bibliographic Details
Published in:Head & neck 2018-01, Vol.40 (1), p.111-119
Main Authors: Mays, Ashley C., Bartels, Harrison G., Wistermayer, Paul R., Rohlfing, Matt L., Gentile, Christopher M., D'Agostino, Ralph, Waltonen, Joshua D.
Format: Article
Language:English
Subjects:
Aged
Body mass index
Cancer
Cohort Studies
Cost Savings
Cost-Benefit Analysis
costs of care
Demography
dysphagia
Enteral Nutrition - economics
Enteral Nutrition - methods
Gastrostomy - economics
Gastrostomy - methods
Head & neck cancer
head and neck cancer
Head and Neck Neoplasms - economics
Head and Neck Neoplasms - pathology
Head and Neck Neoplasms - surgery
head and neck oncology
Health Care Costs
Humans
Length of Stay - economics
Male
Middle Aged
Ostomy
Patient Readmission - economics
Postoperative Care - methods
Preoperative Care - methods
Retrospective Studies
surgical outcomes
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Summary:Background The purpose of this study was to examine the cost differences between preoperative and postoperative placement of gastrostomy tubes (G‐tubes) in patients with head and neck cancer. Methods We conducted a retrospective chart review of patients with aerodigestive tract cancers from 2010 to 2015. Data included inpatient and postdischarge costs, demographics, tumor characteristics, surgical treatment, length of stay (LOS), time spent in the intensive care unit (ICU), and readmissions. Results Five hundred ninety patients were included in this study. There was a $7624 inpatient cost savings (P = .002) for those G‐tubes placed preoperatively ($26 060) versus postoperatively ($33 754). Postdischarge costs did not differ significantly between groups (P = .60). There was a $9248 total costs savings (P = .009) for those patients with G‐tubes placed preoperatively ($39 751) versus postoperatively ($48 999), despite patients with preoperative G‐tubes having lower body mass index (BMI; P = .009), higher Association of Anesthesiologist (ASA) class (P = .02), more preoperative radiation (P 
ISSN:1043-3074
1097-0347
DOI:10.1002/hed.24992