Preoperative resource utilization prior to minimally invasive repair of pectus excavatum - 12/08/21
Abstract |
Background |
Preoperative testing to assess the physiologic impact of pectus excavatum is sometimes ordered to meet third-party payor preauthorization requirements. This study describes the utility of physiologic testing prior to minimally invasive repair of pectus excavatum (MIRPE).
Methods |
We retrospectively reviewed patients that underwent MIRPE from 1/2012–7/2016 at two academic children’s hospitals. Data collected included demographics, insurance, Haller Index (HI), pulmonary function tests (PFTs) and echocardiograms (ECHO) obtained, and preauthorization denials.
Results |
A total of 360 patients (mean age 15.7 ± 2.0 years; mean HI 4.5 ± 1.5) underwent MIRPE (Hospital 1: 189, Hospital 2: 171). Commercial insurers covered 84% of patients. Hospital 1 obtained more frequent preoperative testing (PFTs: 73% vs 6%, p < 0.0001). Overall, 72% of PFTs were normal with abnormal studies limited to mild findings. Similarly, 85% of ECHOs were normal. Third-party payors more frequently denied preauthorization for MIRPE at Hospital 2 (11% vs. 5%, p = 0.03).
Conclusions |
More frequent preoperative testing may decrease initial preauthorization denials for MIRPE; however, this increased utilization of resources may not be necessary as the majority of test results are normal.
Le texte complet de cet article est disponible en PDF.Highlights |
• | Unnecessary preoperative testing in healthy patients increases healthcare spending. |
• | Preoperative testing in children with pectus excavatum at two institutions varies. |
• | More frequent testing is associated with lower rates of third-party payor denials. |
• | The majority of tests in symptomatic children with pectus excavatum were normal. |
• | Routine preoperative testing before pectus repair may be an unnecessary practice. |
Keywords : Pectus excavatum, Preoperative testing, Insurance, Pediatric, Resource utilization
Plan
Vol 222 - N° 3
P. 650-653 - septembre 2021 Retour au numéro
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