Variation in Tympanoplasty Cost in a Multihospital Network

Objectives: Identify costs and operative times for tympanoplasty, and evaluate factors influencing cost and time variation. Study Design: Retrospective cohort study. Setting: Multihospital network. Patients: Patients undergoing tympanoplasty from 2008 to 2016. Subjects with additional procedures were excluded. Interventions: A multihospital network's standardized activity-based accounting system was used to determine costs and operative times of tympanoplasty. Main Outcome Measures: Correlation between variable factors and cost was calculated by Spearman correlation coefficients. Statistical comparisons of cost and time were made between surgeons and hospitals using an ANOVA test (Kruskal–Wallis) followed by Dunn's test to correct for multiple comparisons. All providers or hospitals with single cases were excluded for statistical comparison. Results: The study cohort included 487 tympanoplasties performed by 44 surgeons at 13 hospitals. Mean patient age was 18.2 ± 17.4 years. Mean cut-to-close time was 85.8 ± 56.7 minutes. Mean total encounter cost was $3491 ± $1,627. Substantial factors associated with total encounter cost were anesthesia cost (r = 0.8782; 95% CI 0.852–0.900, p 
Source: Otology and Neurotology - Category: ENT & OMF Tags: MIDDLE EAR AND MASTOID DISEASE Source Type: research