Demonstrating the benefits of a multidisciplinary aerodigestive program

Abstract

Objectives/Hypothesis The Aerodigestive Program (the Aero Program) at Children's Hospital Colorado is a multidisciplinary program focused on airway, digestive, and lung disorders in complex children, involving collaboration between gastroenterology, pulmonology, anesthesiology, and otolaryngology in clinic and operating room. These programs have proliferated as institutions focus on providing greater care coordination and family satisfaction. However, few cost, charge, and satisfaction data exist to support these resource‐intensive programs. The goal of this study was to investigate the value of combined triple endoscopy delivered by the Aero Program through analysis of institutional charges, direct costs, operating room efficiency metrics, and parent satisfaction. Study Design Program evaluation. Methods Finance, satisfaction, efficiency, and quality‐of‐care metrics were evaluated within and outside of the Aero Program through retrospective queries of electronic health records, administrative databases, and parent surveys at our institution. Results Mean anesthesia time in the Aero Program was 54 minutes (49–60; 95% confidence interval), which was significantly less (P < .0001) than the estimated 89 minutes of having the three procedures done separately. Average charges and average direct costs for triple endoscopy were 38.8% and 41.9% less than the sum of the averages for separate procedures, respectively. Parent satisfaction was high for the Aero Program care. Conclusions As organizations move toward greater coordination of care for complex patients, multidisciplinary programs must demonstrate their value by delivering cost‐effective care. Aerodigestive programs have the potential to provide satisfying care that is less costly to the organization, insurer, and family. These programs represent a step in the evolution toward higher value care and value‐based payment methodology. Level of Evidence 4 Laryngoscope, 130:521–525, 2020

Multidisciplinary approach to paediatric aerodigestive disorders: A single‐centre longitudinal observational study

“…10 The benefits of such a model, in the form of aerodigestive programme, has shown to transcend the clinical care and includes improvement in admission rates at the hospital, costs of treatment and family satisfaction. 5,11,12 Our clinic is still in its early stages of operation with only 17 months of data collated currently. The average operational age of similar programmes mostly from North America being 5.3 years (SD = 4.3; range 1-17 years).…”

“…Various studies have emphasised the need for a multidisciplinary team approach for patients with multiple symptoms and interrelated diagnosis, especially in cases of airway, GI and growth issues 10 . The benefits of such a model, in the form of aerodigestive programme, has shown to transcend the clinical care and includes improvement in admission rates at the hospital, costs of treatment and family satisfaction 5,11,12 . Our clinic is still in its early stages of operation with only 17 months of data collated currently.…”

Care recommendations for the respiratory complications of esophageal atresia‐tracheoesophageal fistula

“…This multidisciplinary approach is increasingly used to optimize outcomes in children with recurrent TEF. 108,109…”

Patient Satisfaction and Efficiency Benefits of a Novel Multidisciplinary Rhinology and Allergy Clinic

“…10,12,13 This applies especially to otolaryngology, where multidisciplinary tracheostomy and pediatric hearing management clinics, and a multidisciplinary aerodigestive clinic, have optimized the management and long-term care of patients, and demonstrated high patient satisfaction, treatment compliance, follow up rates, and reduced financial and time burdens on families. 10,14,15…”