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Cost of skin care in the myelomeningocele population
1Department of Surgery, Dartmouth-Hitchcock Medical Center, Hanover, New Hampshire.
Insights
Skin breakdown is a significant issue for children with myelomeningocele, requiring extensive medical resources. Despite care improvements, the problem persists, impacting patient care and hospital costs.
Area of Science:
- Pediatric Medicine
- Surgical Innovation
- Rehabilitation Medicine
Background:
- Myelomeningocele is a severe birth defect impacting mobility and requiring lifelong care.
- Children with myelomeningocele are at high risk for skin breakdown due to immobility and sensory deficits.
- Effective management of skin integrity is crucial for preventing complications and improving quality of life.
Purpose of the Study:
- To determine the prevalence and impact of skin breakdown in pediatric myelomeningocele patients.
- To analyze the healthcare resource utilization for treating skin breakdown in this population.
- To evaluate the effectiveness of contemporary patient care strategies.
Main Methods:
- Retrospective chart review of 75 myelomeningocele patients hospitalized for skin breakdown over 13 years.
- Inclusion criteria: hospitalization exclusively for skin breakdown treatment.
- Data collected included age at admission, length of hospital stay, and treatment costs.
Main Results:
- Skin breakdown remains a prevalent complication in children with myelomeningocele.
- Despite advancements in care, significant hospitalizations were required.
- Treatment costs exceeded $2 million, with 17 years of hospital days documented.
Conclusions:
- Skin breakdown continues to be a major challenge in myelomeningocele care.
- Improved patient care has led to increased age at admission and reduced hospital stays.
- Aggressive management and early intervention are essential but resource-intensive.
Abstract:
This study was undertaken to illustrate the magnitude of the skin breakdown problem in children with myelomeningocele. Seventy-five of the 650 spina bifida patients treated at the Newington Children's Hospital during a 13-year period comprised our final study group. The criterion for inclusion was hospitalization solely for treatment of skin breakdown. Multiple parameters were reviewed. Skin breakdown remains prevalent in this patient population, despite significant improvements in patient care. These improvements are readily demonstrated by (a) an increase in age at time of admission, (b) a significant reduction in average length of hospital stay, and (c) more aggressive admission policies with earlier operative intervention. More than two million dollars and the equivalent of 17 years in hospital days were needed to treat these patients during the 13-year study period.