Cost-minimisation analysis of polysomnography and pulse oximetry in a risk stratification protocol for paediatric adenotonsillectomy
- Details
- Publication Year 2022-09,Volume 92,Issue #9,Page 2292-2298
- Journal Title
- ANZ Journal of Surgery
- Publication Type
- Research article
- Abstract
- BACKGROUND: Severe obstructive sleep apnoea (OSA) is associated with increased risk of respiratory compromise in the post-operative period following adenotonsillectomy (AT). This study analyses the economic cost of polysomnography or overnight oximetry as part of pre-operative risk stratification in paediatric AT, supplementing previously published research demonstrating the efficacy of this protocol in predicting respiratory complications. METHODS: This cost-minimisation analysis examines costs associated with pre-operative overnight oximetry and polysomnography in triaging paediatric patients older than 2 years old, with no major comorbidities except for OSA, undergoing AT for OSA (n = 1801) to either a secondary or quaternary Australian hospital. Decision analysis modelling via probability trees were utilized to estimate pre- and peri-operative costs. A third hypothetical 'no investigation' model based upon conducting all AT at a secondary hospital was performed. Costs are derived from the financial year 2020-2021, censored at discharge. RESULTS: The total cost per patient of AT including pre-operative investigations of oximetry and polysomnography, and associated inpatient costs, were AUD4181.34 and 5013.99 respectively. This is more expensive compared to a hypothetical no-investigation model (AUD3958.98). CONCLUSION: Within the scope of this partial economic evaluation, this study finds a small additional cost for a model of care involving overnight oximetry as a pre-operative triage tool, balanced by the reduced cost of care in a lower acuity centre for low-risk patients and potential high cost of complications if all children are treated in a low acuity centre. This supports oximetry in peri-operative risk stratification for paediatric AT from a financial perspective.
- Keywords
- Australia/epidemiology; Child; Child, Preschool; Humans; *Oximetry/methods; Polysomnography; Retrospective Studies; Risk Assessment; *Sleep Apnea, Obstructive/diagnosis/surgery; adenotonsillectomy (AT); cost-minimisation; obstructive sleep apnoea (OSA); oximetry; respiratory complications
- Department(s)
- Surgical Oncology
- PubMed ID
- 35719108
- Publisher's Version
- https://doi.org/10.1111/ans.17858
- Terms of Use/Rights Notice
- Refer to copyright notice on published article.
Creation Date: 2024-12-20 02:34:29
Last Modified: 2024-12-20 02:39:05