The Community Cost of Maintaining Gastrostomies in Pediatric Patients.

ABSTRACT

The use of gastrostomies in children is increasing and their need for long-term management following insertion presents a potentially significant financial and resource challenge to local healthcare systems. Objectives: The aim of this study was to determine the yearly cost of maintaining a gastrostomy in a pediatric patient. Methods: A retrospective, bottom-up cost-analysis was conducted in a cohort of 180 patients with gastrostomies aged 0-19 years. One in 5 patients were randomly selected for individual cost analysis (n = 36). Their electronic health record was interrogated from the period of March 1, 2019-March 1, 2020. Costs included in the analysis were staff contact time from the community nursing and nutrition teams, and equipment costs. Results: The mean cost of maintaining a pediatric gastrostomy across all ages was £709.87 (SD 403.18) per year. Mean annual cost varied by age, underlying diagnosis, and gastrostomy device, but this variation was only statistically significant for the type of device, with Mic-Key buttons having a mean annual cost of £834.66 (SD 307.85), Mini buttons £799.06 (SD 395.01), and percutaneous endoscopic gastrostomy tubes £279.34 (SD 297.45; P = 0.004). Conclusion: The mean cost of maintaining a gastrostomy in a pediatric patient is just over £700 per year. The cost is the highest as a child enters adulthood. Button devices have higher maintenance costs compared with percutaneous endoscopic gastrostomy tubes.