Related Experiment Video
Updated: Aug 2, 2025
Guidelines for Elective Pediatric Fiberoptic Intubation
Published on: January 17, 2011
Financial Toxicity for Caregivers of Pediatric Patients With Long-Term Tracheostomies
Mattie Rosi-Schumacher1, Ryan Nagy1, Nicole Favre2
1Department of Otolaryngology-Head and Neck Surgery, Jacobs School of Medicine and Biomedical Sciences, State University of New York at Buffalo, Buffalo, NY, USA.
Insights
Caregivers of children with long-term tracheostomies face significant financial toxicity. These families experience higher costs and greater financial strain compared to those with children undergoing typical ear, nose, and throat surgeries.
Area of Science:
- Pediatric Healthcare
- Health Economics
- Otolaryngology
Background:
- Long-term tracheostomies in children necessitate extensive medical care and support.
- Caregiver financial well-being is a critical, yet often overlooked, aspect of pediatric chronic illness management.
- Understanding the economic burden on families is essential for developing targeted support systems.
Purpose of the Study:
- To evaluate the extent of financial toxicity experienced by caregivers of pediatric patients with long-term tracheostomies.
- To compare the financial burden on these caregivers with a control group of caregivers for children undergoing less complex otolaryngologic procedures.
- To identify factors associated with increased financial strain in this population.
Main Methods:
- A cross-sectional survey study was conducted at a tertiary pediatric hospital.
- Caregivers of pediatric patients (<18 years) with tracheostomies for ≥12 months were compared to caregivers of patients undergoing tympanostomy tube placement or adenotonsillectomy.
- The validated Comprehensive Score for Financial Toxicity (COST) survey was administered to assess financial strain.
Main Results:
- Caregivers of children with long-term tracheostomies reported significantly greater financial toxicity (lower COST scores) compared to controls (P < .001).
- The study group had lower mean household income, lower education levels, and were more likely to have public or no health insurance.
- Employment of home nursing care was associated with lower COST scores, indicating increased financial toxicity (P < .001).
Conclusions:
- Caregivers of pediatric patients requiring long-term tracheostomies experience a substantially higher degree of financial toxicity.
- The findings highlight the significant economic impact of chronic pediatric conditions on families.
- Interventions and financial support are crucial for caregivers managing the long-term care of children with tracheostomies.
Objective:
To assess financial toxicity experienced by caregivers of children with long-term tracheostomies.
Methods:
Cross-sectional survey study with comparison group conducted at a tertiary pediatric hospital and outpatient clinic. Pediatric (<18 years) patients with tracheostomies for ≥12 months were recruited for the study. Patients who underwent tympanostomy tube placement or adenotonsillectomy were recruited as controls. Eligible patients' caregivers were contacted to fill out a questionnaire including the validated Comprehensive Score for Financial Toxicity survey.
Results:
Surveys were completed for 72 patients, including 31 in the study group (mean age, 6.58 years, 95% confidence interval [CI], 4.85-8.30 years) and 41 controls (mean age, 6.42 years, 95% CI, 5.15-10.52 years) (P = .864). The mean duration of tracheostomy was 3.98 years (95% CI, 2.91-5.05 years). The mean household income and education level were lower in the study group than in the control group. Caregivers of the study group were more likely to have public health insurance or be uninsured. Caregivers of study patients reported greater financial toxicity, with a lower mean Comprehensive Score for Financial Toxicity (18.23 [95% CI, 15.20-21.25]) than caregivers of controls (34.27 [95% CI, 32.05-36.49]; P < .001). Linear regression analysis showed that survey scores were lower for caregivers who employed home nursing care (P < .001).
Conclusion:
Caregivers of pediatric patients requiring long-term tracheostomies experience greater financial toxicity than caregivers of pediatric patients who have typical otolaryngologic surgery.
Related Concept Videos
01:23Oxygen Delivering System III: Tracheostomy and T-piece
Tracheostomy
A tracheostomy is a surgically created opening (stoma) in the anterior part of the trachea. It is used to establish a patient airway, bypass an upper airway obstruction, simplify the removal of secretions, permit long-term...
01:28Tracheostomy: Procedure and Tubes
Tracheostomy tubes can be made of semiflexible plastic (polyurethane or silicone), rigid plastic, or metal, and they come in...
01:16Oxygen Delivering System II: Venturi Mask and Transtracheal Oxygen
Venturi Mask
The Venturi mask, named after the Venturi effect, is designed to deliver precise oxygen concentrations. It consists of a large tube with an oxygen inlet that narrows down, causing a pressure drop that pulls air in through adjustable side ports. The mask is a lightweight,...
01:25Tracheostomy Care II: Procedure
Step 1: Perform hand hygiene, and put on personal protective equipment: gown, gloves, mask...
01:16Tracheostomy Care I: Pre-procedural Steps
Required Equipment
The equipment necessary for tracheostomy care includes:
01:17Endotracheal Intubation II: Nursing Management
1. Nursing Care of Patients Before Intubation
Before the endotracheal intubation procedure, nurses play an essential role in ensuring the process goes smoothly. The nurses must be familiar with intubation...