Yevgeniy R. Semenov

The effect of pneumonia on short-term outcomes and cost of care after head and neck cancer surgery†

The Centers for Medicare and Medicaid Services has threatened to discontinue reimbursements for ventilator‐associated pneumonia (VAP) as a preventable “never event.” We sought to determine the relationship between pneumonia and in‐hospital mortality, complications, length of hospitalization and costs in head and neck cancer (HNCA) surgery.

Association Between Visuospatial Ability and Vestibular Function in the Baltimore Longitudinal Study of Aging.

To investigate the relationship between vestibular loss associated with aging and age‐related decline in visuospatial function.

Age-dependent cost-utility of pediatric cochlear implantation

Objectives: Cochlear implantation (CI) has become the mainstay of treatment for children with severe-to-profound sensorineural hearing loss (SNHL). Yet, despite mounting evidence of the clinical benefits of early implantation, little data are available on the long-term societal benefits and comparative effectiveness of this procedure across various ages of implantation—a choice parameter for parents and clinicians with high prognostic value for clinical outcome. As such, the aim of the present study is to evaluate a model of the consequences of the timing of this intervention from a societal economic perspective. Average cost utility of pediatric CI by age at intervention will be analyzed. Design: Prospective, longitudinal assessment of health utility and educational placement outcomes in 175 children recruited from six U.S. centers between November 2002 and December 2004, who had severe-to-profound SNHL onset within 1 year of age, underwent CI before 5 years of age, and had up to 6 years of postimplant follow-up that ended in November 2008 to December 2011. Costs of care were collected retrospectively and stratified by preoperative, operative, and postoperative expenditures. Incremental costs and benefits of implantation were compared among the three age groups and relative to a nonimplantation baseline. Results: Children implanted at <18 months of age gained an average of 10.7 quality-adjusted life years (QALYs) over their projected lifetime as compared with 9.0 and 8.4 QALYs for those implanted between 18 and 36 months and at >36 months of age, respectively. Medical and surgical complication rates were not significantly different among the three age groups. In addition, mean lifetime costs of implantation were similar among the three groups, at approximately

The effect of deep venous thrombosis on short-term outcomes and cost of care after head and neck cancer surgery†

2000/child/year (77.5-year life expectancy), yielding costs of

Postoperative urinary tract infection and short-term outcomes and costs in head and neck cancer surgery

14,996,

Vestibular Function and Activities of Daily Living Analysis of the 1999 to 2004 National Health and Nutrition Examination Surveys

17,849, and

The Role of Obliteration in the Achievement of a Dry Mastoid Bowl.

19,173 per QALY for the youngest, middle, and oldest implant age groups, respectively. Full mainstream classroom integration rate was significantly higher in the youngest group at 81% as compared with 57 and 63% for the middle and oldest groups, respectively (p < 0.05) after 6 years of follow-up. After incorporating lifetime educational cost savings, CI led to net societal savings of

Clinical and Societal Outcomes

31,252,

Quality of Life and Cost-Effectiveness of Cochlear Implants: A Narrative Review

10,217, and

Urinary Tract Infections after Head and Neck Cancer Surgery

6,680 for the youngest, middle, and oldest groups at CI, respectively, over the child’s projected lifetime. Conclusions: Even without considering improvements in lifetime earnings, the overall cost-utility results indicate highly favorable ratios. Early (<18 months) intervention with CI was associated with greater and longer quality-of-life improvements, similar direct costs of implantation, and economically valuable improved classroom placement, without a greater incidence of medical and surgical complications when compared to CI at older ages.