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No place like home: Discharge timing and costs following pediatric gastrostomy tube placement in the United States

Johanna M Borst1, Alexandra Highet2, John B Rode1

  • 1Division of Pediatric Surgery, Department of Surgery, Ann & Robert H. Lurie Children's Hospital of Chicago, Northwestern University Feinberg School of Medicine, Chicago, IL, USA.

Journal of Pediatric Surgery
|July 9, 2026
PubMed

Insights

Same-day discharge (SDD) after pediatric gastrostomy tube placement significantly lowers costs by about $17,000 per patient. However, SDD adoption remains low and uneven across hospitals, highlighting an opportunity for improved value in pediatric surgical care.

Area of Science:

  • Pediatric Surgery
  • Healthcare Economics
  • Quality Improvement

Background:

  • Same-day discharge (SDD) is proven safe for select pediatric gastrostomy tube placement patients.
  • Current adoption trends of SDD in the United States are not well-documented.
  • This study examines recent SDD utilization and associated costs.

Purpose of the Study:

  • To evaluate the association between same-day discharge (SDD) and adjusted estimated costs.
  • To analyze temporal trends and hospital-level variation in SDD for pediatric gastrostomy tube placement.
  • To identify opportunities for improving value in pediatric surgical care.

Main Methods:

  • Retrospective cohort study of children (≤18 years) undergoing elective gastrostomy tube placement (2016-2025).
  • Utilized the Pediatric Health Information System database, excluding cases with additional procedures.
  • Compared costs and analyzed trends using generalized linear and logistic regression models, adjusting for multiple variables.

Main Results:

  • SDD occurred in 9.8% of 11,818 encounters across 46 hospitals.
  • SDD was associated with 31% lower costs (approx. $17,000 per encounter).
  • SDD increased from 4.7% (2016) to 12.0% (2025) but adoption was uneven, with high-volume hospitals dominating.

Conclusions:

  • Same-day discharge after pediatric gastrostomy tube placement significantly reduces healthcare costs.
  • Limited and uneven hospital adoption of SDD persists despite proven benefits.
  • Standardized perioperative pathways can enhance SDD adoption and improve value in pediatric surgery.
Abstract

Keywords:
GastrostomyHospital costsLength of stayPediatric surgerySame-day discharge

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