Interdisciplinary Care Eases Pediatric Aerodigestive Disorder Burden

Implementing interdisciplinary care reduces anesthetic exposures and related costs for pediatric patients with complex respiratory and gastrointestinal disorders, according to research published in JAMA Otolaryngology-Head & Neck Surgery.

Researchers from the Johns Hopkins Medical Institutions in Baltimore retrospectively examined the medical records of 125 pediatric patients with aerodigestive disorders, whose mean age was 1.51 years. Although such patients frequently require more care from specialists, the researchers noted that the effectiveness of interdisciplinary care in this population is unknown and not often studied.

All study subjects were treated at the Pediatric Aerodigestive Center (PAC), an academic pediatric tertiary care center, between June 2010 and August 2013. At the initial visit, each patient received an average of 2.9 of 4 possible interdisciplinary consulting services from gastroenterology, otolaryngology, pulmonology, and speech-language pathology specialists.

Evaluation under anesthesia was recommended for 85 patients (68%), with an outcome of 267 operations requiring 158 doses of general anesthesia. As a result, there were 109 fewer episodes of anesthesia, which reduced both the risks of such sedation and related care costs by nearly $2000 per avoided episode. The researchers also suggested that the reductions in anesthesia use could also reduce neurocognitive risks associated with multiple anesthetic exposures.

“Although we observed a reduction in potential charges for medical care and a reduction in the number of episodes of anesthesia, there are certainly other nontangible benefits associated with the coordination of care that our study did not capture. Specifically, such potential benefits may include direct medical benefits of more rapid diagnoses and treatment, better communication between clinicians, decreased wait times for families to receive a coordinated plan of care, and indirect benefits such as improved caregiver satisfaction,” the authors wrote. “…Other nontangible benefits associated with the coordination of care, such as caregiver satisfaction, warrant further study.”