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Open versus percutaneous dilatational tracheostomy: efficacy and cost analysis
A Grover1, J Robbins, P Bendick
1Department of Surgery, William Beaumont Hospital, Royal Oak, Michigan, USA.
The American Surgeon
|April 20, 2001
Summary
Open bedside tracheostomy is more cost-effective than percutaneous dilatational tracheostomy, saving significant institutional resources. Both methods are safe, but the open bedside approach offers better utilization of resources.
Area of Science:
- Medical Economics
- Surgical Procedures
- Respiratory Care
Background:
- Percutaneous dilatational tracheostomy (PDT) and open tracheostomy (OT) are common airway management techniques.
- Previous studies focused on operating room PDT economics.
- Institutional comparison of OT and PDT costs at the bedside is needed.
Purpose of the Study:
- To compare the costs and charges of PDT with OT at the bedside.
- To evaluate resource utilization and cost-effectiveness of different tracheostomy methods.
Main Methods:
- Retrospective analysis of patients undergoing tracheostomy.
- Categorization into three groups: OT in OR (Group I), OT at bedside (Group II), PDT at bedside (Group III).
- Comparison of institutional costs and charges for each procedure.
Main Results:
- Open tracheostomy at the bedside demonstrated cost savings of $180 and charge savings of $658 per procedure versus PDT at the bedside.
- Open tracheostomy in the operating room incurred higher costs ($2194) and charges ($2871) compared to bedside OT.
- Annual savings of approximately $31,500 (cost) and $109,000 (charges) were estimated for bedside OT versus PDT.
Conclusions:
- Both open bedside tracheostomy and percutaneous dilatational tracheostomy are safe and reasonable options.
- Open tracheostomy at the bedside is more cost-effective and represents better resource utilization.
- Open bedside tracheostomy is the preferred procedure at the institution due to economic advantages.