Costs of Sleep Endoscopy With Same‐Day Versus Staged Surgery for Pediatric Obstructive Sleep Apnea

Abstract Objective To compare the costs of staged versus same‐day surgery after drug‐induced sleep endoscopy (DISE) for pediatric obstructive sleep apnea (OSA). Study Design Retrospective cohort study. Setting Single tertiary‐care center in the United States from 2017 to 2023. Methods Patients were...

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Main Authors: Nicholas R. Lenze, Michael M. Allevato, William J. Benjamin, Emmanuel Servin, Erin M. Kirkham, David A. Zopf, Joseph G. Sinnwell
Format: Article
Language:English
Published: Wiley 2025-04-01
Series:OTO Open
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Online Access:https://doi.org/10.1002/oto2.70133
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author Nicholas R. Lenze
Michael M. Allevato
William J. Benjamin
Emmanuel Servin
Erin M. Kirkham
David A. Zopf
Joseph G. Sinnwell
author_facet Nicholas R. Lenze
Michael M. Allevato
William J. Benjamin
Emmanuel Servin
Erin M. Kirkham
David A. Zopf
Joseph G. Sinnwell
author_sort Nicholas R. Lenze
collection DOAJ
description Abstract Objective To compare the costs of staged versus same‐day surgery after drug‐induced sleep endoscopy (DISE) for pediatric obstructive sleep apnea (OSA). Study Design Retrospective cohort study. Setting Single tertiary‐care center in the United States from 2017 to 2023. Methods Patients were grouped into two surgical pathways: (1) DISE with same‐day OSA surgery and (2) DISE with staged OSA surgery. Nonparametric tests and log‐normal models were used to compare insurance payments, out‐of‐pocket costs, and hospital costs between pathways and to evaluate predictors of hospital costs. Results A total of 57 pediatric OSA patients with a mean (standard deviation [SD]) age of 10.8 (4.0) years were included. The mean insurance payments, out‐of‐pocket costs, and hospital costs were $12,158 (SD 10,412), $340 (SD 1168), and $11,965 (SD 9615), respectively. Patients who underwent DISE with staged OSA surgery had significantly higher hospital costs than those who underwent DISE with same‐day OSA surgery (mean difference $8995, 95% CI 3528‐14462; P < .001), and this effect persisted in an adjusted log‐normal model (coefficient 0.82, 95% CI 0.34‐1.30; P = .001). There were no significant differences in insurance payments or out‐of‐pocket costs by surgical pathway. Conclusion DISE with staged OSA surgery conferred higher hospital costs than DISE with same‐day OSA surgery but did not increase financial burden on patients or payers. This finding has important implications for resource utilization for a common pediatric condition.
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spelling doaj-art-ce5fca382a394d12a6fcf97e3d8807b42025-08-20T03:32:42ZengWileyOTO Open2473-974X2025-04-0192n/an/a10.1002/oto2.70133Costs of Sleep Endoscopy With Same‐Day Versus Staged Surgery for Pediatric Obstructive Sleep ApneaNicholas R. Lenze0Michael M. Allevato1William J. Benjamin2Emmanuel Servin3Erin M. Kirkham4David A. Zopf5Joseph G. Sinnwell6Department of Otolaryngology–Head and Neck Surgery University of Michigan Medical School Ann Arbor Michigan USADepartment of Otolaryngology–Head and Neck Surgery University of Michigan Medical School Ann Arbor Michigan USADepartment of Otolaryngology Head and Neck Surgery Harvard Medical School Boston Massachusetts USADepartment of Otolaryngology–Head and Neck Surgery University of Michigan Medical School Ann Arbor Michigan USADepartment of Otolaryngology–Head and Neck Surgery University of Michigan Medical School Ann Arbor Michigan USADepartment of Surgery University of Wisconsin School of Medicine and Public Health, Division of Otolaryngology–Head & Neck Surgery Madison Wisconsin USADepartment of Otolaryngology Wake Forest University School of Medicine Winston Salem North Carolina USAAbstract Objective To compare the costs of staged versus same‐day surgery after drug‐induced sleep endoscopy (DISE) for pediatric obstructive sleep apnea (OSA). Study Design Retrospective cohort study. Setting Single tertiary‐care center in the United States from 2017 to 2023. Methods Patients were grouped into two surgical pathways: (1) DISE with same‐day OSA surgery and (2) DISE with staged OSA surgery. Nonparametric tests and log‐normal models were used to compare insurance payments, out‐of‐pocket costs, and hospital costs between pathways and to evaluate predictors of hospital costs. Results A total of 57 pediatric OSA patients with a mean (standard deviation [SD]) age of 10.8 (4.0) years were included. The mean insurance payments, out‐of‐pocket costs, and hospital costs were $12,158 (SD 10,412), $340 (SD 1168), and $11,965 (SD 9615), respectively. Patients who underwent DISE with staged OSA surgery had significantly higher hospital costs than those who underwent DISE with same‐day OSA surgery (mean difference $8995, 95% CI 3528‐14462; P < .001), and this effect persisted in an adjusted log‐normal model (coefficient 0.82, 95% CI 0.34‐1.30; P = .001). There were no significant differences in insurance payments or out‐of‐pocket costs by surgical pathway. Conclusion DISE with staged OSA surgery conferred higher hospital costs than DISE with same‐day OSA surgery but did not increase financial burden on patients or payers. This finding has important implications for resource utilization for a common pediatric condition.https://doi.org/10.1002/oto2.70133childcostendoscopylaryngoscopyobstructive sleep apneasurgery
spellingShingle Nicholas R. Lenze
Michael M. Allevato
William J. Benjamin
Emmanuel Servin
Erin M. Kirkham
David A. Zopf
Joseph G. Sinnwell
Costs of Sleep Endoscopy With Same‐Day Versus Staged Surgery for Pediatric Obstructive Sleep Apnea
OTO Open
child
cost
endoscopy
laryngoscopy
obstructive sleep apnea
surgery
title Costs of Sleep Endoscopy With Same‐Day Versus Staged Surgery for Pediatric Obstructive Sleep Apnea
title_full Costs of Sleep Endoscopy With Same‐Day Versus Staged Surgery for Pediatric Obstructive Sleep Apnea
title_fullStr Costs of Sleep Endoscopy With Same‐Day Versus Staged Surgery for Pediatric Obstructive Sleep Apnea
title_full_unstemmed Costs of Sleep Endoscopy With Same‐Day Versus Staged Surgery for Pediatric Obstructive Sleep Apnea
title_short Costs of Sleep Endoscopy With Same‐Day Versus Staged Surgery for Pediatric Obstructive Sleep Apnea
title_sort costs of sleep endoscopy with same day versus staged surgery for pediatric obstructive sleep apnea
topic child
cost
endoscopy
laryngoscopy
obstructive sleep apnea
surgery
url https://doi.org/10.1002/oto2.70133
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