Economic Study of a Pediatric Tracheostomy Remote Home Monitoring Program (PTRHMP) Compared to Prolonged Hospitalization for Children With Tracheostomy

IF 1.7 4区医学 Q2 OTORHINOLARYNGOLOGY

Laryngoscope Investigative Otolaryngology Pub Date : 2025-06-18 DOI:10.1002/lio2.70167

Adele K. Evans

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Abstract

Background/Context

Home health nursing is considered critical to transition to at-home care after pediatric tracheostomy. This diminishing resource contributes a barrier to at-home care. Telemedicine (Bluetooth wireless technology for monitoring vital signs, Wi-Fi data transfer to a centralized monitoring center for alarm response) could add support for families during this transition. This manuscript compares a retrospective evaluation of observed hospital costs to modeled estimates for a Pediatric Tracheostomy Remote Home Monitoring Program (PTRHMP): equipment alarm monitoring, call-to-home confirmation, and a centralized database of critical information for Emergency Medical Services (EMS) dispatch.

Key Methods

(1) Cost of Care Cohort analysis of in-patient cost of care for pediatric tracheostomy patients using retrospective chart review. (2) Modeled cost estimates using a financial proforma developed by experts in the field. (3) Comparative Analysis of Cost of Care Cohort versus PTRHMP proforma. (4) Potentially avoidable Adverse Event analysis.

Results

Thirty-three candidates met inclusion criteria for the Cost of Care Cohort Analysis. Average LOS was 31.6 days longer than target LOS, was influenced by average number of caregivers (p < 0.0001) and by age at tracheostomy placement (p = 0.038; 1), and averaged ($17,000/day billed, $3000/day payments received) 10 times the cost estimated for the PTRHMP proforma ($285 per patient-day).

Conclusion

The widespread adoption of a Pediatric Tracheostomy Remote Home Monitoring Program (PTRHMP) appears to be technologically and financially tenable at one tenth the cost of in-patient care. Patients under the age of 2 at tracheostomy placement may represent a separate subgroup for analysis. An implementation study is required to determine the level of safety compared to currently available conditions.

Level of Evidence

2—Cohort Study.

Abstract Image

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儿童气管切开术远程家庭监测项目（PTRHMP）与气管切开术儿童延长住院时间的经济研究

背景/背景家庭健康护理被认为是儿童气管切开术后过渡到家庭护理的关键。这种日益减少的资源成为家庭护理的障碍。远程医疗（用于监测生命体征的蓝牙无线技术，用于警报响应的Wi-Fi数据传输到集中监测中心）可以在这一过渡期间为家庭提供支持。本文对观察到的医院费用的回顾性评估与儿科气管切开术远程家庭监测计划（PTRHMP）的模型估计进行了比较：设备报警监测、电话到家确认和紧急医疗服务（EMS）调度关键信息的集中数据库。(1)护理成本采用回顾性图表法对小儿气管切开术患者住院护理成本进行队列分析。(2)使用该领域专家开发的财务形式对成本进行建模估算。(3)护理成本队列与PTRHMP形式的比较分析。(4)潜在可避免不良事件分析。结果33名候选人符合护理成本队列分析的纳入标准。平均生存时间比目标生存时间长31.6天，受护理人员平均人数（p < 0.0001）和气管造口术放置年龄(p = 0.038；1)，平均（17000美元/天账单，3000美元/天付款）是PTRHMP形式估计成本（285美元/病人/天）的10倍。结论：广泛采用儿童气管切开术远程家庭监测项目（PTRHMP）在技术和经济上似乎是可行的，其成本仅为住院治疗的十分之一。2岁以下气管造口放置的患者可能代表一个单独的亚组进行分析。需要进行一项实施研究，以确定与现有条件相比的安全水平。证据水平2队列研究。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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