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Medical Costs of Patients Undergoing Esophageal Atresia Repair are Mainly Influenced by Associated Malformations
Nicolas Pardey1, Jan Zeidler1, Jochen Blaser2
1Center for Health Economics Research Hannover (CHERH), Leibniz University Hannover, Hannover, Germany.
Insights
This study reveals that the first year of life for esophageal atresia (EA) patients incurs significant costs, especially when complications arise. Associated malformations and surgical issues dramatically increase healthcare expenses for these rare disease patients.
Area of Science:
- Pediatric Surgery
- Healthcare Economics
- Neonatal Care
Background:
- Esophageal atresia (EA) is a rare congenital condition requiring early surgical intervention.
- Patients with EA often have comorbidities and need intensive postoperative care.
- Limited data exists on the first-year healthcare costs associated with EA.
Purpose of the Study:
- To investigate the economic burden of esophageal atresia during the first year of life.
- To identify factors influencing healthcare costs in EA patients.
Main Methods:
- Analysis of anonymized claims data from Techniker Krankenkasse (approx. 10.8 million clients).
- Inclusion of patients diagnosed with EA (ICD: Q39.0 or Q39.1) and undergoing esophageal reconstruction (OPS: 5-428.0 to 5-428.7, 5-316.1 or 5-431.0) in their first year of life.
- Follow-up for 1 year, analyzing costs, hospital stay duration, and mechanical ventilation using descriptive statistics and multiple linear regression.
Main Results:
- The mean 1-year cost for EA patients was €89,736 ± €97,419.
- Patients with associated malformations and surgical complications incurred nearly five-fold higher costs (€193,103 ± €157,507) compared to those without (€39,846 ± €33,473).
- Average mechanical ventilation duration was 23.2 ± 43.1 days, and mean hospital stay was 80.3 ± 77.2 days.
Conclusions:
- This is the first study to assess the first-year costs for esophageal atresia patients.
- Associated malformations and surgical complications significantly escalate healthcare costs in EA patients.
- Understanding these costs is crucial for resource allocation and patient management.
Background:
Esophageal atresia (EA) is a rare disease requiring surgical repair, usually within the first days of life. Patients with EA require intensive postoperative care and often have comorbidities. There is a lack of data on the costs incurred by patients with EA during the first year of life.
Methods:
Anonymized claims data were provided by the Techniker Krankenkasse (∼10.8 million clients). Data were extracted for patients who had an inpatient diagnosis of EA (International Classification of Diseases [ICD]: Q39.0 or Q39.1) and a reconstruction of the esophageal passage in case of atresia (Operationen-und Prozedurenschlüssel [German version of ICPM, International Classification of Procedures in Medicine; OPS] 5-428.0 to 5-428.7, 5-316.1 or 5-431.0) during their first hospital stay. All patients were in their first year of life at initial hospitalization (2016-2020) and were followed up for 1 year. Costs, length of hospital stay, and duration of mechanical ventilation and differentiated OPS services were analyzed using descriptive statistics. Multiple linear regression was used to analyze the determinants of hospital costs.
Results:
A total of 119 patients with EA were included (55.5% male). The mean cost of the 1-year observation period was €89,736 ± 97,419 (range €12,755-640,154). The increasing costs of the initial hospitalization led to a disproportionate increase in the costs of the 1-year observation period. The presence of an associated malformation combined with surgical complications was associated with almost five-fold higher costs than in patients without an associated malformation and an uncomplicated course (€193,103 ± 157,507 vs. €39,846 ± 33,473). The mean duration of mechanical ventilation was 23.2 ± 43.1 days and the mean length of hospital stay was 80.3 ± 77.2 days.
Conclusion:
To our knowledge, this is the first study to investigate the costs of EA patients in the first year of life. The presence of an associated malformation combined with surgical complications was associated with almost five-fold higher costs than in patients without an associated malformation and an uncomplicated course.
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