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Cost-effectiveness of simultaneous versus sequential surgery in head and neck reconstruction
Kevin K Wong1, Danny J Enepekides, Kevin M Higgins
1Department of Otolaryngology–Head and Neck Surgery, Sunnybrook Health Sciences Centre, University of Toronto, 2075 Bayview Avenue, Toronto, Ontario.
Summary
Simultaneous head and neck reconstruction significantly reduces operating time and costs compared to sequential surgery. This approach offers a more cost-effective solution for oncologic patients requiring complex reconstructive procedures.
Area of Science:
- Surgical Oncology
- Cost-Effectiveness Analysis
- Head and Neck Surgery
Background:
- Head and neck cancer treatment often necessitates complex ablative and reconstructive surgery.
- Sequential surgical approaches, involving separate teams for ablation and reconstruction, can be time-consuming and costly.
- Optimizing surgical workflow is crucial for improving patient outcomes and resource utilization.
Purpose of the Study:
- To evaluate the cost-effectiveness of simultaneous versus sequential head and neck reconstruction.
- To compare the operative time and direct costs associated with both surgical approaches.
Main Methods:
- A case-controlled study was conducted at a tertiary care hospital.
- Retrospective chart review of oncology patients undergoing free flap reconstruction.
- Pair-matched comparison of sequential and simultaneous surgery groups (n=9 each) using microcosting analysis.
Main Results:
- Simultaneous surgery reduced operative time by an average of 3 hours and 15 minutes.
- This resulted in an approximate cost saving of $1200 per case.
- Represents a ~15% reduction in overall surgical costs.
Conclusions:
- Simultaneous head and neck reconstruction is a more cost-effective strategy than sequential surgery.
- This approach offers significant financial benefits and operational efficiencies.
- Further adoption of simultaneous techniques is recommended for head and neck reconstruction.