title: Cost of treating sagittal synostosis in the first year of life.
abstract: BACKGROUND
  Endoscopically assisted suturectomy (EAS) has been reported to reduce the morbidity and cost of treating sagittal synostosis when compared with traditional open cranial vault remodeling (CVR) procedures. Whereas the former claim is well substantiated and intuitive, the latter has not been validated by rigorous cost analysis.
  
  
  METHODS
  Patient medical records and financial database reports were culled retrospectively to determine the total cost associated with both EAS and CVR during 1 year of care. Recorded cost data included physician and hospital services, orthotic equipment and fittings, and indirect patient cost.
  
  
  RESULTS
  Ten patients treated with CVR were compared with 10 patients who underwent EAS. The CVR patients incurred greater costs in nearly all categories studied, including overall 1-year costs, physician services, hospital services, supplies/equipment, medications/intravenous fluids, and laboratory and blood bank services. Postoperative costs were greater in the EAS group, primarily because of the cost associated with orthotic services and indirect patient costs for travel and lost work. However, overall indirect patient costs for the whole year did not differ between the groups. One-year median costs were $55,121 for CVR and $23,377 for EAS. Early clinical results were similar for the 2 groups.
  
  
  CONCLUSIONS
  Cranial vault remodeling was more costly in the first year of treatment than EAS, although indirect patient costs were similar. The favorable cost of EAS compared with CVR provides further justification to consider this procedure as first-line treatment of sagittal synostosis in young infants.
authors.affiliation: Harvard Medical School, Department of Plastic and Oral Surgery, Children's Hospital Boston, Boston, MA 02115, USA.
authors.forename: Megan M
authors.initials: MM
authors.lastname: Abbott
authors.forename: Gary F
authors.initials: GF
authors.lastname: Rogers
authors.forename: Mark R
authors.initials: MR
authors.lastname: Proctor
authors.forename: Kathleen
authors.initials: K
authors.lastname: Busa
authors.forename: John G
authors.initials: JG
authors.lastname: Meara
mesh_terms: D000041:Absenteeism; D001803:Blood Transfusion / Q000191:economics; D017281:Cost of Illness; D003365:Costs and Cost Analysis; D003393:Cranial Sutures / Q000002:abnormalities*; D003398:Craniosynostoses / Q000191:economics / Q000601:surgery*; D003399:Craniotomy / Q000191:economics; D004180:Direct Service Costs; D004358:Drug Therapy / Q000191:economics; D004724:Endoscopy / Q000191:economics; D004865:Equipment and Supplies, Hospital / Q000191:economics; D005260:Female; D005440:Fluid Therapy / Q000191:economics; D017048:Health Care Costs; D017721:Hospital Costs; D006801:Humans; D007223:Infant; D007755:Laboratories, Hospital / Q000191:economics; D007902:Length of Stay / Q000191:economics; D008297:Male; D019060:Minimally Invasive Surgical Procedures / Q000191:economics; D009989:Orthotic Devices / Q000191:economics; D010294:Parietal Bone / Q000002:abnormalities*; D010820:Physicians / Q000191:economics; D011183:Postoperative Complications / Q000191:economics; D019651:Plastic Surgery Procedures / Q000191:economics*; D012189:Retrospective Studies; D014186:Transportation / Q000191:economics; D016896:Treatment Outcome