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Pediatric Otolaryngology Procedure Duration by Training Level: 12,704 Case Analysis
Christopher Jabbour1, Nicole L Aaronson1,2, Ran Zhang3
1Division of Pediatric Otolaryngology, Nemours Children's Health, Wilmington, DE, USA.
The Annals of Otology, Rhinology, and Laryngology
|May 23, 2025
Summary
Resident involvement in pediatric otolaryngology procedures increases surgical time, particularly for younger patients and those with specific health factors. This training incurs a significant financial cost to healthcare institutions.
Area of Science:
- Pediatric Otolaryngology
- Healthcare Economics
- Surgical Education
Background:
- Resident training is integral to surgical education.
- Understanding the impact of resident involvement on procedure efficiency and cost is crucial for healthcare systems.
Purpose of the Study:
- To evaluate how resident participation affects the duration of pediatric otolaryngology procedures.
- To analyze the financial implications of resident involvement in surgical care.
Main Methods:
- Retrospective chart review of pediatric otolaryngology procedures (tonsillectomy, adenoidectomy, etc.) from April 2016 to October 2023.
- Data collected included procedure duration, patient demographics, American Society of Anesthesiology (ASA) class, body mass index (BMI) percentile, scheduling time, and surgeon type.
- Financial impact calculated by comparing procedure times between attending physicians and trainees, using institutional revenue values.
Main Results:
- Trainee involvement generally prolonged surgical times compared to attending physicians, except for closed nasal reduction.
- Factors like patient age, ASA class, BMI percentile, and afternoon scheduling were associated with longer procedures for certain operations.
- The financial cost attributed to resident training was estimated at $616,988 over the study period, with the highest investment in second-year residents.
Conclusions:
- Surgical duration in pediatric otolaryngology is influenced by surgeon experience and patient-specific factors.
- Resident training represents a substantial, long-term financial investment for healthcare institutions, essential for developing surgical expertise.
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