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Cost Comparison of Type B Ulnar Polydactyly Excision in the Office and Operating Room
EJun Yun BS, Nikhi P. Singh MD, MBA, Khoa Tran MPH, Craig Brooks MBA, Joshua Adkinson MD, Gregory Borschel MD
Indiana University School of Medicine, Department of Surgery
2024-02-01
Presenter: Nikhi Singh
Affidavit:
I am a student responsible for this work and developed the majority of it
Director Name: William A. Wooden, MD, FACS
Author Category: Resident Plastic Surgery
Presentation Category: Clinical
Abstract Category: Hand
One in 500 children in the US are born with polydactyly, extra digits on the hands or feet. Surgery to remove type B polydactyly are traditionally performed in an operating room (OR) setting. This institutional review board-approved retrospective cost analysis was conducted to compare financial burdens for patients and hospital systems associated with in-office and operating room type B polydactyly excision.
Demographics and financial data for 36 patients undergoing in-office excisions were compared with those of 41 patients undergoing OR excisions between January 2021 to December 2022 were compared. Average total charge to patients, average charge per digit removed per visit, and average total margin per visit were the primary outcomes.
Average total charge to patients was less for the in-office group compared to the OR group ($2,076 vs. $13,079, p<0.001). Average charge to patients per digit removed for the in-office group was less than the OR group ($1,133 vs. $7,889, p<0.001). Documented cost to the healthcare facility was also lower for the in-office group compared to the OR group ($847 vs. $3,289, p<0.001). This contributed to a smaller net negative margin for the in-office group than for the OR group (-$64 vs. -$1,696, p<0.001).
Our study demonstrates that excision of type B ulnar polydactyly in the office greatly decreases the cost burden incurred by patients and their families, as well as the healthcare system. Treating patients with type B ulnar polydactyly in the office may decrease healthcare utilization and costs for all involved.
