Introduction
Methods
Andrade Filho et al. [23] | Bové et al. [24] | Castillo Farias et al. [25] | Chandran et al. [26] | Fang et al. [10] | Hillel et al. [27] | Hogikyan et al. [28] | Howell et al. [20] | Kuo et al. [9] | Naidu et al. [29] | Rees et al. [11] | Schutte et al. [21] | Wellenstein et al. [22] | |
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1. Is the intervention clearly described? | + | + | + | + | + | − | + | + | + | + | + | + | + |
2. Are cost items clearly described? | − | − | − | + | + | + | + | + | + | + | + | + | + |
3. Are all relevant cost items included? | ? | ? | − | + | + / − | + | − | + | + | + / − | + | + | + |
4. Is an adequate source of financial data used? | + | + | + | + | + | + | ? | + | + | ? | + | + | + |
5. Are productivity changes reported? | − | − | − | − | − | + | − | − | − | − | − | − | − |
6. Is the time frame stated? | − | + | + | + | + | + / − | + | + | + | + | + | + | + |
7. Is a sensitivity analysis performed? | − | − | − | − | − | − | − | − | − | − | − | − | − |
8. Are appropriate statistical methods used? | NA | + | NA | + | + | + / − | NA | + | NA | + | NA | NA | + |
9. Is discounting applied? | − | − | − | − | − | − | − | − | − | − | − | − | − |
10. Conflict of interests that could influence results? (+ = no; − = yes or not stated) | − | − | − | + | + | + | − | + | + | − | − | + | + |
Results
Search results and study selection
Data extraction
Author, year, country | Pathology of study population | Intervention | Perspective | Source and included items of OB costs/charges | Source and included items of OR-costs/charges | Results converted to Euros |
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Andrade Filho [23], 2006, USA | Glottal insufficiency | OB-VFI n = 52 OR-VFI n = 10 | Hospital charges | Office billing records: not further specified | Hospital billing records: not further specified | OB charges: €1.212 OR charges: €12.049 |
Bové [24], 2007, USA | Vocal fold atrophy, paresis or paralysis | OB-VFI n = 50 OR-VFI n = 108 | Hospital charges | Hospital billing records: not further specified | Hospital billing records: not further specified | OB charges: €1.472 OR charges: €12.430 (p < 0.05) |
Castillo Farias [25], 2014, Spain | Suspected pharyngo-laryngeal malignancy | FEB and direct laryngoscopy biopsies under GA | Hospital costs | Financial department of hospital (based on general fees): medical supplies, biopsy/cytology | Financial department of hospital (based on general fees): pre-operative examinations, pre-anesthesiology visit, surgery and related costs, pathology | OB costs: €57 OR costs: €1.101 |
Chandran [26], 2017, Australiaa | Vocal fold paralysis | OB-VFI n = 14 (in OR) OR-VFI n = 6 × | Hospital costs | Financial department of the hospital: ward costs (medical, nursing, and supplies), operating theatre costs (theatre nursing, surgeon, and anesthetic), allied health, depreciation, overhead expenditures, hotel, non-clinical costs, in-patient admissions, outpatient visits, emergency department visits, pathology, radiology, medication, nursing, and medical staff, associated overheads | OB costs: €980 OR costs: €1.622 p < 0.001 | |
Fang [10], 2015, Taiwan | Pharyngo-laryngeal lesion | FEB (n = 20) and direct laryngoscopy biopsies under GA (n = 20) | Hospital costs | National Taiwan health insurance program: physician fee, flexible laryngoscopy, disposable supplies, biopsy procedure fee | NA | OB costs: Hospital €13 Surgeon €97 |
Hillel [27], 2016, USAb | Not stated | OB-VFI n = 16 (in endoscopy suite) OR-VFI n = 16 | Hospital costs and charges | Hospital billings records: pre-operative unit laboratory testing, intravenous fluids, drugs administered, laser fiber or tissue filler, pathology charges, room charges, recovery charges, surgeon fees and anesthesiologist fees (OR-cases only) | OB costs: Hospital €1.456 OB charges: Hospital €2.381 Surgeon €891 OR costs: Hospital €1.870 OR charges: Hospital €6.205 Surgeon €660 Anesthesiologist €661 p = 0.0032 (for costs difference OB vs. OR) | |
Respiratory papillomatosis | TNFLS n = 16 × (in endoscopy suite) TOLMS n = 16 | Hospital costs and charges | Hospital billings records: pre-operative unit laboratory testing, intravenous fluids, drugs administered, laser fiber or tissue filler, pathology charges, room charges, recovery charges, surgeon fees and anesthesiologist fees (OR-cases only) | OB costs: Hospital €1.228 OB charges: Hospital €2.464 Surgeon’s fee €1.006 OR costs: Hospital €2.292 OR charges: Hospital €7.589 Surgeon €759 Anesthesiologist €1.135 | ||
Hogikyan [28], 2000, USA | Suspected pharyngo-laryngeal malignancy | OB-transoral biopsies with rigid laryngoscope (n = 2), direct laryngoscopy biopsies under GA (n = 2) | Hospital charges | Billing records: laryngoscopy, surgeon fee | Billing records: laryngoscopy, esophagoscopy, surgeon fee, anesthesia/OR | OB charges: Hospital €579 OR charges: Hospital €3.583 |
Howell [20], 2018, USA | Esophageal stenosis in patients with HNCA history and dysphagia | OB-TNE balloon dilation (n = 9); OR-Esophageal dilation (n = 9) | Hospital charges | Billing records: clinic visit, outpatient services, speech therapy (physicians fees not included) | Billing records: anesthesia, laboratory, pathology, supplies and devices, OR services, pharmacy, pulmonary function, recovery room, respiratory services, room and board, speech therapy (physician fees not included) | OB charges: Hospital €2.738 OR charges: Hospital €15.090 p < 0.001 |
Kuo [9], 2011, USA | Benign laryngeal pathology | TNFLS n = 6 TOLMS n = 6 | Hospital costs and charges | Hospital billings records: disposable supplies and other materials, anesthesia and medications, equipment, staff, procedural room-related fees, surgeon fee, recovery room and anesthesiologist fee (OR-cases only) | OB costs: Hospital €1.239 OB charges: Hospital €187 Surgeon €946 OR costs: Hospital €1.847 OR charges: Hospital €10.311 Surgeon €1.249 Anesthesiologist €1.287 | |
Naidu [29], 2011, USA | Suspected pharyngo-laryngeal malignancy | FEB (n = 12) and direct laryngoscopy biopsies under GA (n = 5) | Hospital charges | Financial department of hospital: facility, procedure charges, and professional otolaryngology charges | Financial department of hospital: anesthesia charges, OR overheads, surgeon fee and postoperative care | OB charges: Facility €173 Procedure €1.248 Surgeon €455 OR charges: Facility €5.752 Surgeon €435 Anesthesia (incl anesthesiologist’s fee) €2.056 p = 0.0001 |
Rees [11], 2007, USA | Respiratory papilloma-tosis | TNFLS n = 7 TOLMS n = 6 | Hospital charges | Hospital billings records: drugs, supplies, laser charges, office visit, surgeon fee | Hospital billing records: pre-operative assessments, i.v. fluids, drugs, supplies, laser charges, OR, anesthesia, post-anesthetic care unit, anesthesiologist and surgeon fee | OB charges: Hospital €249 Surgeon €1.796 OR charges: Hospital €3.677 Surgeon €3.177 Anesthesiologist €814 |
Schutte [21], 2018, the Netherlands | Suspected pharyngo-laryngeal malignancy | FEB and direct laryngoscopy biopsies under GA | Hospital costs | Financial department of hospital (based on general fees): purchase, depreciation, sterilization of equipment, costs of disposables, salary of involved medical employees | Financial department of hospital (based on general fees): purchase, depreciation, sterilization of equipment, costs of disposables, salary of involved medical employees, institutional rates for day-care | OB costs: Hospital €54 Physician €25 OR costs: Hospital €340 Surgeon €41 Anesthesiologist (incl. OR facility fee) €440 |
Wellenstein [22], 2019, the Netherlands | Hypopharyngeal carcinoma | TNE-assisted biopsies (n = 15) and direct laryngoscopy biopsies under GA (n = 15) | Hospital costs | Financial department of hospital (based on general fees): purchase, depreciation, sterilization of equipment, costs of disposables, outpatient visits, salary of involved medical employees | Financial department of hospital (based on general fees): purchase, depreciation, sterilization of equipment, costs of disposables, outpatient visits, salary of involved medical employees (excl. ENT surgeon), institutional rates for day-care | OB costs: Hospital including physician: €583 OR costs: Hospital €975 Anesthesiologist (incl. OR facility fee) €440 p = 0.000 |
Procedure | Number of studies addressing costs of this procedure |
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Vocal fold injection (VFI) | |
Transnasal flexible laser surgery (TNFLS) | |
Flexible endoscopic (laryngopharyngeal) biopsies (FEB) | |
Transnasal esophageal balloon dilation (TNE-BD) | 1 [20] |
Transnasal esophagoscope-assisted biopsies (TNE-B) | 1 [2] |