Abstract:
OBJECTIVE:Pediatric cochlear implantation (CI) entails surgery followed by lifetime maintenance, and hence incurs both initial and ongoing costs. Previous assessments of these costs were either undertaken early in the evolution of services, or were based on single hospitals, or estimated costs largely from hospital charges. The aim was to overcome these limitations by conducting a multi-center evaluation of the costs of providing unilateral CI to children in the United Kingdom (UK). METHODS:Annual numbers of implantations in all UK pediatric CI programs were monitored prospectively from 1991. Resource use was measured in 12 programs in 1998/1999 and retrospectively back to the year of inception of each program. The profile of outpatient and outreach visits was assessed in the 12 programs. Together these variables were used to estimate health-service costs for four phases of management: pre-operative assessment, implantation, tuning, and subsequent maintenance, using economic micro-costing methods. Costs were subsequently estimated for all children implanted in 1998/1999 (N=199) and were aggregated over 1, 15, and 73 years following implantation. To assess the robustness of cost estimates, parameter values were varied over plausible ranges and costs re-estimated. Total UK health-service costs were also estimated. All costs are presented in euros (1=US dollars 0.98= pound 0.65, 1st July 2002), inflated to 2000/2001 financial-year levels, and discounted at 6% per annum. RESULTS:Per-child average costs were 42972 (1-year), 73763 (15-years), and 95034 (73-years). Cost estimates were not overly sensitive to the value of any one cost component nor to the relative cost of outpatient and outreach visits. When these parameters were varied, costs ranged between 30000 and 47000 (1-year), 61000 and 83000 (15-years), and 82000 and 108000 (73-years). The total UK health-service cost of unilateral pediatric CI was estimated to be 14 million in 2000/2001 and is predicted to rise to 23 million in 2015/2016, if the present model of service-delivery continues. The cost of maintaining implanted children was estimated to account for 22% of the total in 2000/2001 and is predicted to rise to 63% by 2015/2016. CONCLUSIONS:Ongoing costs of maintaining implanted children and their implant systems are significant and should be factored into resource-allocation decisions.
journal_name
Int J Pediatr Otorhinolaryngoljournal_title
International journal of pediatric otorhinolaryngologyauthors
Barton GR,Bloor KE,Marshall DH,Summerfield AQdoi
10.1016/s0165-5876(02)00355-5subject
Has Abstractpub_date
2003-02-01 00:00:00pages
141-9issue
2eissn
0165-5876issn
1872-8464pii
S0165587602003555journal_volume
67pub_type
杂志文章,多中心研究abstract:OBJECTIVE:To assess the impact of the waiting list on the spontaneous resolution of recurrent acute tonsillitis in children. METHODS:We have evaluated 623 cases placed on the waiting list for elective tonsillectomy (with or without adenoidectomy) between February 1994 and May 1999 at our institution. In each child, ag...
journal_title:International journal of pediatric otorhinolaryngology
pub_type: 杂志文章
doi:10.1016/s0165-5876(02)00128-3
更新日期:2002-08-01 00:00:00
abstract:OBJECTIVES:To study the development of craniofacial and dental arch morphology in children with sleep disordered breathing in relation to adenotonsillar surgery. SUBJECTS AND METHODS:From a community-based cohort of 644 children, 393 answered questionnaires at age 4, 6 and 12 years. Out of this group, 25 children who ...
journal_title:International journal of pediatric otorhinolaryngology
pub_type: 杂志文章
doi:10.1016/j.ijporl.2009.10.025
更新日期:2010-02-01 00:00:00
abstract::A case of thyroglossal duct anomaly showing an unusual finding of foci of cartilage is presented. Although the concept of choristoma may explain the pathogenesis of cartilage within the present congenital anomaly, the histologic features were more in favor of a metaplastic process. In addition, the history of recurren...
journal_title:International journal of pediatric otorhinolaryngology
pub_type: 杂志文章
doi:10.1016/0165-5876(88)90072-9
更新日期:1988-05-01 00:00:00
abstract:UNLABELLED:The cause of upper respiratory tract infections (URTI) are multifactorial (enlarged adenoid, environmental conditions, staying at the care centers, smoking parents, allergy). Directly, viral infection causes damage to the ciliary cells and mucociliary clearance in the nasopharynx and Eustachian tube, promote...
journal_title:International journal of pediatric otorhinolaryngology
pub_type: 杂志文章
doi:10.1016/s0165-5876(99)00178-0
更新日期:1999-10-05 00:00:00
abstract::An analysis of the results of 100 temporalis fascia underlay myringoplasties in children between the ages of 2-17 years is presented. The follow-up period in this retrospective review was from 6 to 24 months. There was no statistically significant correlation between the age of patient, a history of previous ear surge...
journal_title:International journal of pediatric otorhinolaryngology
pub_type: 杂志文章
doi:10.1016/0165-5876(94)01067-8
更新日期:1995-01-01 00:00:00
abstract:INTRODUCTION:The Sinus and Nasal Quality of Life Survey (SN-5) is a validated quality of life (QOL) questionnaire for chronic rhinosinusitis in patients age 2-12. Its utility in the cystic fibrosis (CF) has been studied, but not yet validated. The purpose of this study is to determine the effectiveness of the SN-5 for ...
journal_title:International journal of pediatric otorhinolaryngology
pub_type: 杂志文章
doi:10.1016/j.ijporl.2017.09.014
更新日期:2017-11-01 00:00:00
abstract::Recent work has shown that resolution of otitis media with effusion (OME) following adenoidectomy may be related to certain preoperative radiographic parameters. This study was performed to investigate the relationship between the total nasal resistance (TNR), adenoid volume and the radiographic palatal airway and ade...
journal_title:International journal of pediatric otorhinolaryngology
pub_type: 杂志文章
doi:10.1016/0165-5876(89)90090-6
更新日期:1989-05-01 00:00:00
abstract::The sternocleidomastoid tumor of infancy is an uncommon clinical entity which has received little attention in the otolaryngological literature. The diagnosis must be considered in any infant presenting with a lateral neck mass. Although its natural history favors spontaneous regression, the mass may initially grow in...
journal_title:International journal of pediatric otorhinolaryngology
pub_type: 杂志文章
doi:10.1016/0165-5876(87)90105-4
更新日期:1987-10-01 00:00:00
abstract::Congenital rests of gastric epithelium have been reported in a variety of head and neck locations. Presenting symptoms of these lesions range from an asymptomatic cyst to one which is compromising the airway. The true diagnosis is rarely suspected prior to excision. A case of a gastric choristoma of the tongue is pres...
journal_title:International journal of pediatric otorhinolaryngology
pub_type: 杂志文章
doi:10.1016/0165-5876(92)90070-6
更新日期:1992-07-01 00:00:00
abstract:OBJECTIVES:The aim was to compare, on the same dataset, existing detection criteria for transiently evoked otoacoustic emissions (TEOAEs) and to select those most suitable for use with school-aged children. METHODS:TEOAEs were recorded from the ears of 187 schoolchildren (age 8-10 years) using the Otodynamics ILO 292 ...
journal_title:International journal of pediatric otorhinolaryngology
pub_type: 杂志文章
doi:10.1016/j.ijporl.2015.06.028
更新日期:2015-09-01 00:00:00
abstract:OBJECTIVE:Phospholipase A2 (PLA2) plays a major part in growth regulation, differentiation and inflammation. It has been proposed as an evaluating marker for infection and inflammation. The aim of this study was to investigate activity of serum type II secretory PLA2 (sPLA2 IIa) in obstructive sleep apnea (OSA) and rec...
journal_title:International journal of pediatric otorhinolaryngology
pub_type: 杂志文章
doi:10.1016/j.ijporl.2011.12.026
更新日期:2012-04-01 00:00:00
abstract::We describe a new stent design for treatment of persistent buccopharyngeal membrane. The patient is a male child diagnosed at birth with persistent buccopharyngeal membrane, managed in our institution from birth to present age of 2.5 years. We describe to problems and challenges in management for this rare anomaly by ...
journal_title:International journal of pediatric otorhinolaryngology
pub_type: 杂志文章
doi:10.1016/j.ijporl.2006.04.009
更新日期:2006-09-01 00:00:00
abstract::The phonetic activity of the velopharyngeal valve has been the subject of electromyographic, radiological, ultrasonic, endoscopic, and of various acoustic and aeromechanical investigations. The subject of the present study was the non-phonetic activities of the velopharyngeal valve. Ten patients were assessed by nasen...
journal_title:International journal of pediatric otorhinolaryngology
pub_type: 杂志文章
doi:10.1016/0165-5876(90)90143-f
更新日期:1990-01-01 00:00:00
abstract:INTRODUCTION:Otitis Media with Effusion (OME) is the most common cause of hearing impairment in the pediatric population. Pediatric obesity is another major health issue with numerous reported health consequences, however, published studies about its role in OME are limited. This study aims to investigate the impact of...
journal_title:International journal of pediatric otorhinolaryngology
pub_type: 杂志文章
doi:10.1016/j.ijporl.2020.110005
更新日期:2020-06-01 00:00:00
abstract:OBJECTIVES:Early diagnosis of congenital hearing loss is fundamental to minimize the negative consequences on the speech development. To lower the age at diagnosis and at intervention in hearing impaired children, not only universal newborn hearing screening (NHS) but also tracking is considered essential. The aim of t...
journal_title:International journal of pediatric otorhinolaryngology
pub_type: 杂志文章
doi:10.1016/j.ijporl.2018.01.035
更新日期:2018-04-01 00:00:00
abstract:OBJECTIVE:Antrochoanal polyp (ACP) is a polypoid lesion originating from the maxillary sinus, emerging from the ostium and extending to the choana. Although the etiologic causes of ACP are not known completely, it presents a fairly uniform clinical appearance. Nitric oxide (NO) has an important role in non-specific imm...
journal_title:International journal of pediatric otorhinolaryngology
pub_type: 杂志文章
doi:10.1016/s0165-5876(02)00405-6
更新日期:2003-04-01 00:00:00
abstract:OBJECTIVE:Olfaction is important for nutrition, safety, and quality of life. Detecting smell loss in young children can be difficult, since many children with olfactory deficits do not recognize their problem and may even pretend to smell. The short attention span of some young children precludes testing with longer st...
journal_title:International journal of pediatric otorhinolaryngology
pub_type: 杂志文章
doi:10.1016/j.ijporl.2012.11.022
更新日期:2013-03-01 00:00:00
abstract::The effect of a beclomethasone dipropionate nasal spray on middle ear effusion was tested in a double-blind study of drug vs placebo (vehicle). Seventy children, aged 4-14 years, sprayed each nostril twice daily for one month. Among them 35 received a daily dose of 400 micrograms of the beclomethasone. The results of ...
journal_title:International journal of pediatric otorhinolaryngology
pub_type: 临床试验,杂志文章
doi:10.1016/0165-5876(82)90088-x
更新日期:1982-06-01 00:00:00
abstract::Hydatid disease is caused by the parasitic tapeworm Echinococcus. This parasite in larval stage can thrive in many parts of the body, most commonly in the liver and the lung. Hydatid disease in the head and neck is uncommon and hydatid cyst presents rarely as a cervical mass. Cervical vertebral echinococcosis is rare....
journal_title:International journal of pediatric otorhinolaryngology
pub_type: 杂志文章
doi:10.1016/s0165-5876(03)00059-4
更新日期:2003-06-01 00:00:00
abstract:OBJECTIVES:The objectives of this study were to discuss the clinical magnifications and therapies of tracheobronchial foreign body aspiration (FBA) in children causing life-threatening complications. METHOD:We retrospectively reviewed 38 cases of FBA with serious complications in children out of 749 cases of FBA in ch...
journal_title:International journal of pediatric otorhinolaryngology
pub_type: 杂志文章
doi:10.1016/j.ijporl.2009.08.003
更新日期:2009-12-01 00:00:00
abstract::Second branchial cleft cysts and sinuses rarely present diagnostic problems to the pediatric otolaryngologist as their course is usually predictable based on consistent embryologic development. However, we evaluated two fistula tracts that did not fit the classic description of second branchial tract fistulas. Upon ra...
journal_title:International journal of pediatric otorhinolaryngology
pub_type: 杂志文章
doi:10.1016/s0165-5876(98)00077-9
更新日期:1998-11-15 00:00:00
abstract:OBJECTIVES:Patient injuries in children can have lifelong effects on the patient and a marked impact on the whole family. The aim of this study was to identify the errors and incidents leading to patient injuries in pediatric otorhinolaryngology (ORL) by evaluating accepted patient injury claims. METHODS:The records o...
journal_title:International journal of pediatric otorhinolaryngology
pub_type: 杂志文章
doi:10.1016/j.ijporl.2019.02.007
更新日期:2019-05-01 00:00:00
abstract:OBJECTIVE:Craniofacial malformations comprise diverse diagnoses, implying a wide range of morbidity and disability among populations. Our aim was to study them as a group and describe their epidemiological factors inside a population as well as finding common risk factors for their presentation in Colombia. METHODS:We...
journal_title:International journal of pediatric otorhinolaryngology
pub_type: 杂志文章
doi:10.1016/j.ijporl.2009.07.012
更新日期:2009-10-01 00:00:00
abstract::Squamous cell carcinoma of the hypopharynx is extremely rare in children. We present a 13-year-old girl with squamous cell carcinoma of the hypopharynx whose father was a coal-miner and a heavy smoker. ...
journal_title:International journal of pediatric otorhinolaryngology
pub_type: 杂志文章
doi:10.1016/j.ijporl.2005.01.026
更新日期:2005-07-01 00:00:00
abstract:OBJECTIVE:There has been much recent focus on sclerotherapy treatment of lymphatic malformations with OK432. Surgical treatment however can have a number of advantages, including complete curative excision. The aim of this study was to evaluate the results of surgical excision as the primary (first) treatment for this ...
journal_title:International journal of pediatric otorhinolaryngology
pub_type: 杂志文章
doi:10.1016/j.ijporl.2011.02.009
更新日期:2011-05-01 00:00:00
abstract:OBJECTIVES:This study aimed to investigate the practical application of Smart Hearing, a new hearing screening system for preschool children. METHODS:The screening system was applied to 6288 preschool children. The system auto-tested hearing thresholds at three frequencies: 1kHz, 2kHz, and 4kHz; a 30dB hearing level (...
journal_title:International journal of pediatric otorhinolaryngology
pub_type: 杂志文章
doi:10.1016/j.ijporl.2013.11.026
更新日期:2014-02-01 00:00:00
abstract::A 35-month-old child presented to the Emergency Department with a suspected coin ingestion. A physical examination and radiographic examination revealed no evidence of the coin, and the child was prepared for discharge. When the child continued to refuse to drink, digital examination of the hard palate revealed the co...
journal_title:International journal of pediatric otorhinolaryngology
pub_type: 杂志文章
doi:10.1016/s0165-5876(00)00399-2
更新日期:2000-10-16 00:00:00
abstract:OBJECTIVES:To determine if the clinical presentation of thyroglossal duct cysts (TGDC) varies between children and adults and whether this knowledge helps optimize the surgical management. METHODS:We retrospectively identified all patients with TGDC managed in our department between 1992 and 2002. We reviewed the pati...
journal_title:International journal of pediatric otorhinolaryngology
pub_type: 杂志文章
doi:10.1016/j.ijporl.2003.07.006
更新日期:2003-12-01 00:00:00
abstract::In children, persistent upper airway obstruction may lead to increased pulmonary arterial pressure (PAP). Allergic rhinitis (AR) is one of the frequent cause of persisting upper airway obstruction by nasal blockage in childhood. Regular use of nasal topical corticosteroids are effective in reducing nasal blockage and ...
journal_title:International journal of pediatric otorhinolaryngology
pub_type: 杂志文章
doi:10.1016/s0165-5876(01)00500-6
更新日期:2001-07-30 00:00:00
abstract::The congenital absence of the epiglottis is a very rare anomaly. We present a patient who has a complete absence of the epiglottis, illustrated with an endoscopic photograph, review the literature and discuss the management of patients with this condition. ...
journal_title:International journal of pediatric otorhinolaryngology
pub_type: 杂志文章
doi:10.1016/s0165-5876(98)00082-2
更新日期:1998-10-15 00:00:00