Reconstruction of facial defects after skin cancer removal can occur in a traditional hospital-based operating room (OR) or an office clinic-based setting. A study led by researchers at Vanderbilt University Medical Center compared cost-effectiveness for the reconstruction of facial skin cancer defects in the OR and clinic setting, revealing significant cost benefits.
The study, which was published Oct. 8 in Otolaryngology-Head and Neck Surgery, summarized the cost differences of head and neck reconstructive surgery for facial defects after skin cancer removal based on the procedural setting. Analyzing 1,206 patient cases from an insurance claim database, the researchers found that OR reconstruction cases had a higher median baseline cost of $2,308 compared to $987 for clinic procedures.
This study utilized a unique metric, the Incremental Cost-Effectiveness Ratio (ICER), to characterize the cost-effectiveness of different operative procedures. It measures the costs associated with original procedures, postoperative follow-up visits, and revision procedures accrued over six months. It also includes the patient satisfaction scores from an institutional database.
Overall, clinic-based reconstruction procedures are cost-effective and provide similar patient satisfaction to OR procedures. This study emphasizes that it would be economical to transition into clinic-based reconstructive surgery for skin cancer defects when possible
Rahul K. Sharma, MD, a resident at Vanderbilt University Medical Center, is the study’s lead author and conducted this research under the mentorship of senior author Priyesh Patel, MD, assistant professor in the Division of Facial Plastic and Reconstructive Surgery and residency program director for Otolaryngology – Head & Neck Surgery at VUMC.
Other Vanderbilt authors on the study are Montana Upton, MD, Avi Vaidya, MPH, Elizabeth Longino, MD, Feyisayo Adegboye, Nicole Desisto, Scott Stephan, MD, and Shiayin Yang, MD.
