Cost-Effectiveness of Cochlear Implantation of Children

2015 ◽  
pp. 201-206 ◽  
Author(s):  
John Hutton ◽  
Claudio Politi ◽  
Thomas Seeger
Keyword(s):  
Cost Effectiveness ◽  
Cochlear Implantation

scholarly journals Cost-effectiveness of pediatric bilateral cochlear implantation in Spain

2017 ◽  
Vol 127 (12) ◽  
pp. 2866-2872 ◽  
Author(s):  
Jorge Pérez-Martín ◽  
Miguel A. Artaso ◽  
Francisco J. Díez
Keyword(s):  
Cost Effectiveness ◽  
Cochlear Implantation

Bilateral, simultaneous cochlear implantation in children: surgical considerations

2009 ◽  
Vol 123 (8) ◽  
pp. 837-839 ◽  
Author(s):  
L Migirov ◽  
J Kronenberg
Keyword(s):  
Cost Effectiveness ◽  
Cochlear Implantation ◽  
Clinical Care ◽  
Operation Time ◽  
Study Cohort ◽  
General Anaesthetic ◽  
Safe Procedure ◽  
Operative Complications ◽  
Post Operative Complications

AbstractProblem:The advantages of bilateral, simultaneous cochlear implantation include: the possibility to pre-empt cochlear calcification following meningitis; reduction of the intervention to only one procedure, general anaesthetic and course of clinical care (with obvious benefits for the patient); and greater cost-effectiveness. The disadvantages of such a procedure include: doubling the risk of associated complications; placing the patient on the implanted side during contralateral implantation; the possibility of vestibular alteration simultaneously in both ears; the need for precise planning of symmetrical incisions and implant sites; and longer surgery time.Methods:The study cohort included 10 children who underwent bilateral, simultaneous cochlear implantation using the suprameatal approach.Results:The overall operation time, inclusive of anaesthesia, was approximately three hours in all cases. None of the children had any intra- or post-operative complications.Conclusions:From a surgical perspective, bilateral, simultaneous cochlear implantation is a safe procedure. The use of a non-mastoidectomy approach is recommended.

Cost Effectiveness of Childhood Cochlear Implantation and Deaf Education in Nicaragua

2015 ◽  
Vol 36 (8) ◽  
pp. 1349-1356 ◽  
Author(s):  
James E. Saunders ◽  
David M. Barrs ◽  
Wenfeng Gong ◽  
Blake S. Wilson ◽  
Karen Mojica ◽  
...  
Keyword(s):  
Cost Effectiveness ◽  
Cochlear Implantation ◽  
Deaf Education

EVIDENCE OF IMPROVING COST-EFFECTIVENESS OF PEDIATRIC COCHLEAR IMPLANTATION

2003 ◽  
Vol 19 (2) ◽  
pp. 421-431 ◽  
Author(s):  
T. Sach ◽  
C. O'Neill ◽  
D.K. Whynes ◽  
S.M. Archbold ◽  
G.M. O'Donoghue
Keyword(s):  
Cost Effectiveness ◽  
Cochlear Implantation ◽  
Speech Intelligibility ◽  
Multivariate Regression Analysis ◽  
Policy Implications ◽  
Confounding Variables ◽  
Auditory Performance ◽  
A Prospective Study ◽  
The Cost ◽  
Over Time

Objectives: To examine the cost-effectiveness of pediatric cochlear implantation over time.Methods: A prospective study based on ninety-eight children implanted between 1989 and 1996 at Nottingham's Paediatric Cochlear Implantation Programme, UK. The influence of outcomes and other variables on total costs was examined using multivariate regression analysis.Results: Having controlled for potential confounding variables, total cost was negatively related to year of implant and positively related to the number of hours of rehabilitation (p=.000).Conclusions: Having controlled for outcomes (Categories of Auditory Performance and Speech Intelligibility Rating), the cost-effectiveness improved over time. This finding may be due to a learning curve and have policy implications.

Expanding Access: Cost-effectiveness of Cochlear Implantation and Deaf Education in Asia

2019 ◽  
Vol 161 (4) ◽  
pp. 672-682 ◽  
Author(s):  
Susan D. Emmett ◽  
Chad K. Sudoko ◽  
Debara L. Tucci ◽  
Wenfeng Gong ◽  
James E. Saunders ◽  
...  
Keyword(s):  
Sensitivity Analysis ◽  
Cost Effectiveness ◽  
Cochlear Implantation ◽  
Deaf Education ◽  
Cost Effective ◽  
World Health ◽  
Annual Number ◽  
Published Data ◽  
Middle Income ◽  
Life Years

Objective To determine the cost-effectiveness of cochlear implantation (CI) with mainstream education and deaf education with sign language for treatment of children with profound sensorineural hearing loss in low- and lower-middle income countries in Asia. Study Design Cost-effectiveness analysis. Setting Bangladesh, Cambodia, India, Indonesia, Nepal, Pakistan, Philippines, and Sri Lanka participated in the study. Subjects and Methods Costs were obtained from experts in each country with known costs and published data, with estimation when necessary. A disability-adjusted life-years model was applied with 3% discounting and 10-year length of analysis. A sensitivity analysis was performed to evaluate the effect of device cost, professional salaries, annual number of implants, and probability of device failure. Cost-effectiveness was determined with the World Health Organization standard of cost-effectiveness ratio per gross domestic product (CER/GDP) per capita <3. Results Deaf education was cost-effective in all countries except Nepal (CER/GDP, 3.59). CI was cost-effective in all countries except Nepal (CER/GDP, 6.38) and Pakistan (CER/GDP, 3.14)—the latter of which reached borderline cost-effectiveness in the sensitivity analysis (minimum, maximum: 2.94, 3.39). Conclusion Deaf education and CI are largely cost-effective in participating Asian countries. Variation in CI maintenance and education-related costs may contribute to the range of cost-effectiveness ratios observed in this study.

scholarly journals Cost-Effectiveness of Intraoperative CT Scanning in Cochlear Implantation in Fee-for-Service and Bundled Payment Models

2020 ◽  
pp. 014556132095219
Author(s):  
Margaret B. Mitchell ◽  
Robert F. Labadie
Keyword(s):  
Computed Tomography ◽  
Cost Effectiveness ◽  
Cochlear Implantation ◽  
Improve Patient Care ◽  
Well Being ◽  
Published Data ◽  
Fee For Service ◽  
Intraoperative Computed Tomography ◽  
Bundled Payment ◽  
Payment Models

Objective: Electrode array tip fold-over is a complication of cochlear implant surgery that results in poor hearing outcomes and often leads to revision surgery. However, tip fold-over can be corrected immediately if identified through intraoperative computed tomography, which also potentially provides information about final intracochlear positioning. Our objective was to provide the first economic analysis of intraoperative computed tomography by generating models in fee-for-service and bundled payment reimbursement structures of payer and institutional cost-effectiveness of this technology used in cochlear implantation over 1, 5, and 10-year time periods. Methods: Cost data specific to a commerically available intraoperative computed tomography machine was obtained from the manufacturer, Xoran Technologies. Institutional tip fold-over rate was obtained from already published data. Medicare reimbursement rate for cochlear implantation was obtained from institutional accountants. Private payer reimbursement for and cost of revision cochlear implantation were estimated based on available data. Results and Conclusion: At large volume centers, cost-effectiveness of this technology is possible in both fee-for-service and bundled payment reimbursement structures at various time points dependent on payer mix. Even low volume cochlear implantation centers (<150 per year) can financially benefit from intraoperative computed tomography in bundled payment models at 5- and 10-year periods regardless of payer mix. This model demonstrates key factors at play in determining cost-effectiveness of this technology including institutional factors and payer type and suggests this technology can align incentives both to improve patient care and outcomes with institutional and payer financial well-being.

scholarly journals Age Dependent Cost-Effectiveness of Cochlear Implantation in Adults. Is There an Age Related Cut-off?

2019 ◽  
Vol 40 (7) ◽  
pp. 892-899 ◽  
Author(s):  
Roman D. Laske ◽  
Michael Dreyfuss ◽  
Alan Stulman ◽  
Dorothe Veraguth ◽  
Alexander M. Huber ◽  
...  
Keyword(s):  
Cost Effectiveness ◽  
Cochlear Implantation ◽  
Age Related ◽  
Age Dependent

scholarly journals Cost-effectiveness of Preoperative Staphylococcus aureus Screening and Decolonization in Cochlear Implantation

OTO Open ◽  
2019 ◽  
Vol 3 (3) ◽  
pp. 2473974X1986639
Author(s):  
Gregory J. Kirchner ◽  
Hovhannes Ghazaryan ◽  
Alexander M. Lieber ◽  
Anisha Reddy Sunkerneni ◽  
Brian J. McKinnon
Keyword(s):  
Staphylococcus Aureus ◽  
Cost Effectiveness ◽  
Infection Rate ◽  
Cochlear Implantation ◽  
Absolute Risk ◽  
Absolute Risk Reduction ◽  
Infection Prophylaxis ◽  
Intranasal Mupirocin ◽  
Mupirocin Ointment ◽  
The Cost

Objective Infection following cochlear implantation is medically and economically devastating. The cost-effectiveness (CE) of colonization screening and decolonization for infection prophylaxis in cochlear implantation has not been examined. Study Design An analytic observational study of data collected from purchasing records and the literature. Methods Costs of Staphylococcus aureus colonization screening and decolonization were acquired from purchasing records and the literature. Infection rates after cochlear implantation and average total costs for evaluation and treatment were obtained from a review of the literature. A break-even analysis was performed to determine the required absolute risk reduction (ARR) in infection rate to make colonization screening or decolonization CE. Results Nasal screening ($144.07) is CE if the initial infection rate (1.7%) had an ARR of 0.60%. Decolonization with 2% intranasal mupirocin ointment ($5.09) was CE (ARR, 0.02%). A combined decolonization technique (2% intranasal mupirocin ointment, chlorhexidine wipes, chlorhexidine shower, and prophylactic vancomycin: $37.57) was CE (ARR, 0.16%). Varying infection rate as high as 15% demonstrated that CE did not change by maintaining an ARR of 0.16%. CE of the most expensive decolonization protocol was enhanced as the cost of infection treatment increased, with an ARR of 0.03% at $125,000. Conclusions Prophylactic S aureus decolonization techniques can be CE for preventing infection following cochlear implantation. Decolonization with mupirocin is economically justified if it prevents at least 1 infection out of 5000 implants. S aureus colonization screening needed high reductions in infection rate to be CE.

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