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Cost Analysis of the PITT Experience in Minimally Invasive Surgery versus Open Repair of Sagittal Craniosynostosis

Andrew Kochuba, Ali Ayyash, Joseph Losee, Jessie Goldstein
University of Pittsburgh Medical Center
2018-02-11

Presenter: Andrew Kochuba

Affidavit:
Andrew Kochuba is responsible for the entirely of this project.

Director Name: Dr. Vu Nguyen

Author Category: Fellow Plastic Surgery
Presentation Category: Clinical
Abstract Category: Craniomaxillofacial

Background: Craniosynostosis occurs when fibrous sutures prematurely fuse in the skull. Open surgical repair is the mainstay of treatment but less invasive techniques are becoming more prevalent. Outcomes analyses have mainly focused on safety; however, little work has focused on cost savings. Our purpose is to compare the costs of minimally invasive and open craniosynostosis repair.

Methods: Retrospective review was performed on patients treated with strip craniectomies and spring cranioplasty or open craniosynostosis repair at Children's Hospital of Pittsburgh between 2014-2017. The total hospital cost, supplies, salaries/benefits, services, administrative, surgery, and physician fees were collected. A cost analysis was performed comparing minimally invasive to open repair.

Results: A total of 27 minimally invasive surgeries and 17 open craniosynostosis repairs were performed. The average surgery cost $11,346 for minimally invasive versus $35,453 for open. A cost comparison for minimally invasive versus open repair yielded: supplies ($2,489 vs $13,268), salaries/benefits ($2,383 vs $7,343), services ($4,699 vs $10,426), administrative ($1,649 vs $4,415), and physician fees ($12,767 vs $37,735). The total admission/inpatient cost $35,363 for minimally invasive versus $108,642 for open surgery.

Conclusion: The treatment mainstay for craniosynostosis has traditionally been open surgery. Recently, minimally invasive surgery has gained traction due to the emphasis to minimize costs while maximizing care. Our study compared the costs of minimally invasive surgery and open craniosynostosis repair at the Children's Hospital of Pittsburgh from 2014-2017. Minimally invasive surgery was found to cost less while having a shorter and less expensive overall hospital course than open surgical repair.

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