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The Community Cost of Maintaining Gastrostomies in Pediatric Patients
Jasmine Makker1, Caroline Pardy2, Veronica Kelly3,4
1From the GKT School of Medical Education, King's College London, London, United Kingdom.
Insights
The yearly cost to maintain a pediatric gastrostomy is over £700. Button devices are more expensive than percutaneous endoscopic gastrostomy tubes, with costs increasing as children approach adulthood.
Area of Science:
- Pediatric Healthcare Management
- Health Economics
- Medical Device Costs
Background:
- The increasing use of gastrostomies in children presents a significant financial and resource challenge.
- Long-term management of pediatric gastrostomies requires substantial healthcare system resources.
Purpose of the Study:
- To determine the average annual cost of maintaining a gastrostomy in pediatric patients.
- To analyze cost variations based on patient age, diagnosis, and gastrostomy device type.
Main Methods:
- Retrospective, bottom-up cost-analysis of 180 pediatric gastrostomy patients (aged 0-19 years).
- Individual cost analysis (n=36) using electronic health records from March 2019 to March 2020.
- Included costs: community nursing/nutrition staff time and equipment.
Main Results:
- The mean annual cost for pediatric gastrostomy maintenance was £709.87.
- Costs varied significantly by gastrostomy device type (p=0.004).
- Mic-Key buttons (£834.66) and Mini buttons (£799.06) were more costly than percutaneous endoscopic gastrostomy tubes (£279.34).
Conclusions:
- Pediatric gastrostomy maintenance costs exceed £700 annually.
- Button devices incur higher maintenance costs than percutaneous endoscopic gastrostomy tubes.
- Costs escalate as pediatric patients transition into adulthood.
Abstract:
The use of gastrostomies in children is increasing and their need for long-term management following insertion presents a potentially significant financial and resource challenge to local healthcare systems.
Objectives:
The aim of this study was to determine the yearly cost of maintaining a gastrostomy in a pediatric patient.
Methods:
A retrospective, bottom-up cost-analysis was conducted in a cohort of 180 patients with gastrostomies aged 0-19 years. One in 5 patients were randomly selected for individual cost analysis (n = 36). Their electronic health record was interrogated from the period of March 1, 2019-March 1, 2020. Costs included in the analysis were staff contact time from the community nursing and nutrition teams, and equipment costs.
Results:
The mean cost of maintaining a pediatric gastrostomy across all ages was £709.87 (SD 403.18) per year. Mean annual cost varied by age, underlying diagnosis, and gastrostomy device, but this variation was only statistically significant for the type of device, with Mic-Key buttons having a mean annual cost of £834.66 (SD 307.85), Mini buttons £799.06 (SD 395.01), and percutaneous endoscopic gastrostomy tubes £279.34 (SD 297.45; P = 0.004).
Conclusion:
The mean cost of maintaining a gastrostomy in a pediatric patient is just over £700 per year. The cost is the highest as a child enters adulthood. Button devices have higher maintenance costs compared with percutaneous endoscopic gastrostomy tubes.
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