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Clinical Outcomes and Financial Impact of a POEM Program at a Rural Tertiary Medical Center: Our First Five Years
Joseph Bethea1, Brandon Peine1, Tyler Fleming1
1Department of General Surgery, East Carolina University, Greenville, NC, USA.
Innovations (Philadelphia, Pa.)
|January 17, 2025
Summary
Per oral endoscopic myotomy (POEM) significantly improved achalasia symptoms and reduced costs over five years. This minimally invasive procedure offers clinical benefits and financial advantages for hospital systems and rural communities.
Area of Science:
- Gastroenterology
- Minimally Invasive Surgery
- Health Economics
Background:
- Achalasia is a rare esophageal motility disorder.
- Per oral endoscopic myotomy (POEM) is an advanced endoscopic treatment for achalasia.
- Evaluating the long-term impact of POEM programs is crucial for healthcare systems.
Purpose of the Study:
- To assess the 5-year clinical and financial outcomes of a POEM program.
- To evaluate the impact on a hospital system and its served rural community.
- To compare POEM costs with traditional surgical methods.
Main Methods:
- Retrospective evaluation of clinical and financial data for POEM patients.
- Postoperative assessment using the GERD-HRQL questionnaire.
- Cost comparison with robot-assisted laparoscopic Heller myotomy.
Main Results:
- 107 patients underwent POEM over 5 years.
- 88.2% reported no/minimal dysphagia; 93.4% reported no/minimal reflux.
- POEM program increased case volume and reduced encounter costs by ~$6,000 compared to robotic Heller myotomy.
Conclusions:
- POEM program demonstrated effectiveness in treating achalasia.
- Significant positive financial impact for the hospital and community.
- POEM is a valuable treatment option for achalasia in a rural tertiary care setting.
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