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Cost Analysis of a Multidisciplinary Aerodigestive Clinic: Are Such Clinics Financially Feasible?

Abstract Multidisciplinary clinics offer important value to pediatric patients with complex conditions that overlap specialties; however, such labor-intensive clinics are difficult to facilitate. We performed a cost analysis of our pediatric multidisciplinary aerodigestive clinic (MADC) to assess its financial feasibility at our tertiary care institution.
PMID
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Authors

Mayor MeshTerms

Digestive System Diseases

Pediatrics

Respiratory Tract Diseases

Tertiary Care Centers

Keywords

aerodigestive clinic

clinic revenue

multidisciplinary clinic

value based care

Journal Title the annals of otology, rhinology, and laryngology
Publication Year Start




PMID- 28397559
OWN - NLM
STAT- MEDLINE
DA  - 20170411
DCOM- 20170418
LR  - 20170418
IS  - 1943-572X (Electronic)
IS  - 0003-4894 (Linking)
VI  - 126
IP  - 5
DP  - 2017 May
TI  - Cost Analysis of a Multidisciplinary Aerodigestive Clinic: Are Such Clinics
      Financially Feasible?
PG  - 401-406
LID - 10.1177/0003489417699420 [doi]
AB  - OBJECTIVE: Multidisciplinary clinics offer important value to pediatric patients 
      with complex conditions that overlap specialties; however, such labor-intensive
      clinics are difficult to facilitate. We performed a cost analysis of our
      pediatric multidisciplinary aerodigestive clinic (MADC) to assess its financial
      feasibility at our tertiary care institution. METHOD: Revenue was based on net
      collections for clinic, professional, and hospital setting charges generated
      during 12 consecutive monthly MADCs beginning August 2013. Clinic charges
      included facility and speech pathologist fees. Professional charges included
      clinic and operative fees generated by providers and anesthesiologist. Hospital
      setting fees included facility and material charges for technical procedures.
      Direct expense calculations included all providers and staff salaries, benefits, 
      and supply costs. RESULTS: Charge capture for 54 consecutive patients seen during
      the study time included new visits 99203-99205 (n = 63), consults 99243-99245 (n 
      = 60), and follow-up visits 99212-99215 (n = 196). Sixty percent of patients
      underwent a clinic nasopharyngeal or laryngeal endoscopy (92511 or 31575), and
      60% underwent subsequent intraoperative procedures with 1 (n = 8) or 2 to 3
      services (n = 24). Program net revenue totaled $828 136 and direct costs $518
      867, accounting for a net positive margin of $309 269. CONCLUSIONS: When
      including direct downstream revenue, our MADC operates on a net positive margin, 
      making it financially feasible.
FAU - Mudd, Pamela A
AU  - Mudd PA
AD  - 1 Department of Otolaryngology, Head and Neck Surgery, Children's National Health
      Services, Washington, DC, USA.
FAU - Silva, Allison L
AU  - Silva AL
AD  - 2 Joseph E. Roberts, Jr. Center for Surgical Care, Children's National Health
      Services, Washington, DC, USA.
FAU - Callicott, Susan S
AU  - Callicott SS
AD  - 2 Joseph E. Roberts, Jr. Center for Surgical Care, Children's National Health
      Services, Washington, DC, USA.
FAU - Bauman, Nancy M
AU  - Bauman NM
AD  - 1 Department of Otolaryngology, Head and Neck Surgery, Children's National Health
      Services, Washington, DC, USA.
LA  - eng
PT  - Journal Article
DEP - 20170322
PL  - United States
TA  - Ann Otol Rhinol Laryngol
JT  - The Annals of otology, rhinology, and laryngology
JID - 0407300
SB  - AIM
SB  - IM
MH  - Child
MH  - Cost-Benefit Analysis
MH  - *Digestive System Diseases/diagnosis/therapy
MH  - Feasibility Studies
MH  - Humans
MH  - Patient Care Team/economics/organization & administration
MH  - *Pediatrics/economics/methods
MH  - *Respiratory Tract Diseases/diagnosis/therapy
MH  - Retrospective Studies
MH  - *Tertiary Care Centers/economics/organization & administration/statistics &
      numerical data
MH  - United States
OTO - NOTNLM
OT  - aerodigestive clinic
OT  - clinic revenue
OT  - multidisciplinary clinic
OT  - value based care
EDAT- 2017/04/12 06:00
MHDA- 2017/04/19 06:00
CRDT- 2017/04/12 06:00
AID - 10.1177/0003489417699420 [doi]
PST - ppublish
SO  - Ann Otol Rhinol Laryngol. 2017 May;126(5):401-406. doi: 10.1177/0003489417699420.
      Epub 2017 Mar 22.

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