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Clinic-based Treatment of Type B Ulnar Polydactyly Saves Costs Compared With Treatment in the Operating Room
Nikhi P Singh1, EJun Yun2, Khoa Tran1
1From the Division of Plastic Surgery, Department of Surgery, Indiana University, Indianapolis, IN.
Insights
In-office excision of type B ulnar polydactyly is significantly more cost-effective than operating room procedures. This approach reduces financial burdens for families and healthcare systems, optimizing resource allocation.
Area of Science:
- Pediatric Surgery
- Health Economics
- Congenital Hand Anomalies
Background:
- Polydactyly affects 1 in 500 US children.
- Type B ulnar polydactyly excision is a common procedure.
- Surgical setting (in-office vs. operating room) impacts costs.
Purpose of the Study:
- To compare the costs of type B ulnar polydactyly excision in an office setting versus an operating room.
- To analyze cost differences for patients, families, and healthcare systems.
Main Methods:
- Retrospective review of 114 patients from January 2019 to December 2023.
- Categorization into in-office or operating room excision groups.
- Analysis of patient demographics and financial data using statistical tests (t-tests, chi-squared, ANOVA).
Main Results:
- In-office excision was significantly less expensive for payers ($2130 vs. $10,731) and health systems ($845 vs. $2349).
- Cost per digit removed was lower for in-office procedures ($1218 vs. $5937).
- All cost comparisons showed statistically significant differences (P < 0.001).
Conclusions:
- In-office excision of type B ulnar polydactyly offers substantial cost savings.
- Shifting care to an office setting can reduce operating room demand and financial strain.
- Findings support informed care planning and resource allocation for polydactyly treatment.
Background:
One in 500 children in the United States is born with polydactyly. Type B ulnar polydactyly excision is often performed in the operating room (OR) but can also be conducted in an office setting. This study compares costs for patients/families and healthcare systems between these settings.
Methods:
A retrospective review from January 2019 to December 2023 included patients who underwent type B ulnar polydactyly excision. Patients were categorized into in-office or OR groups. Patient demographics and financial data were analyzed using independent-samples t tests, χ2 tests, and analysis of variance (significance: P < 0.05).
Results:
Of 114 patients, 64 underwent in-office excision and 50 underwent OR excision. Total charges to the payer were significantly lower for in-office excision compared with OR ($2130 versus $10,731; P < 0.001). The average cost per digit removed was also less for in-office procedures ($1218 versus $5937; P < 0.001). Health system costs were lower for in-office excision overall ($845 versus $2349; P < 0.001) and per digit ($472 versus $1272; P < 0.001).
Conclusions:
In-office excision of type B ulnar polydactyly significantly reduces costs for patients, families, and healthcare systems. Shifting care to the office can alleviate OR demand and decrease financial burdens. These cost differences should inform care planning and resource allocation.
