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Late-Breaking Scientific Oral Presentations

Pediatric Otolaryngology

Session: Late-Breaking Scientific Orals: Facial Plastic and Reconstructive Surgery and Pediatric Otolaryngology

The Role of Sustainability and Regionalization of Esophagoscopy for Pediatric Esophageal Foreign Bodies

Monday, September 30, 2024
8:42 AM – 8:48 AM EDT
Location: MBCC, 222
Disclosure(s):
Tanya Chen, MD:

faculty for this accredited education activity has no relationship(s) with ineligible companies to disclose.

Yasmine Madan:

faculty for this accredited education activity has no relationship(s) with ineligible companies to disclose.

Peter J. Gill, MD:

faculty for this accredited education activity has no relationship(s) with ineligible companies to disclose.

Evan J. Propst, MD, MSc:

faculty for this accredited education activity has no relationship(s) with ineligible companies to disclose.

Introduction: Impacted pediatric esophageal foreign bodies (EFBs) are often transferred to specialized pediatric hospitals for removal in the operating room. Our objective was to assess the environmental impact of esophagoscopy and propose regionalization of pediatric esophagoscopy as a model for cost savings.

Methods: A retrospective study of patients undergoing esophagoscopy for EFB removal at a tertiary pediatric hospital from 2010 to 2021 was performed. Characteristics of each EFB, patient transfer, and hospital course were collected. Healthcare costs were calculated using hospital-specific costs and provincial fees. Carbon footprint was estimated by calculating carbon emissions associated with resource usage and patient transfer.

Results: A total of 680 patients were included. The total amount spent on pediatric esophageal foreign bodies from 2010-2021 was $2,673,288. The mean total cost per child with an EFB was $3,469. On average, a child who was transferred to a tertiary care center cost $1,965 more than a child initially presenting to a tertiary care center (p = 0.001). Of all patients, 65% presented to a community hospital initially with a lower-risk foreign body impaction. If lower-risk foreign bodies were managed initially at the community hospital, this would result in a cost savings of $246,111 over the study period (9% of the total cost spending) and overall reduction of 8.3 metric tons of CO2.

Conclusions: EFBs pose a significant economic burden to the healthcare system, driven by frequent transfers to pediatric tertiary care centers. Improving the capacity of community hospitals to manage EFB when possible is a cost-efficient, sustainable initiative to reduce healthcare-related carbon emissions.

    Presenting Author(s)

  • Tanya Chen, MD

    Resident
    University of Toronto
    Toronto, ON, Canada

    Disclosure(s):

    faculty for this accredited education activity has no relationship(s) with ineligible companies to disclose.

    • Co-Author(s)

  • Jennifer M. Siu, MD, MPH

    Otolaryngologist
    University of Toronto
    Toronto, Ontario, Canada

    Disclosure information not submitted.

  • Yasmine Madan

    Undergraduate Student
    Hospital for Sick Children
    Toronto, Ontario, Canada

    Disclosure(s):

    faculty for this accredited education activity has no relationship(s) with ineligible companies to disclose.

  • PG

    Peter J. Gill, MD

    Pediatrician, Scientist
    Hospital for Sick Children
    Toronto, ON, Canada

    Disclosure(s):

    faculty for this accredited education activity has no relationship(s) with ineligible companies to disclose.

  • NC

    Nicholas Carman, MD

    Hospital for Sick Children, United States

    Disclosure information not submitted.

  • Evan J. Propst, MD, MSc

    Professor
    Hospital for Sick Children
    Toronto, United States

    Disclosure(s):

    faculty for this accredited education activity has no relationship(s) with ineligible companies to disclose.

    • Senior Author(s)

  • Nikolaus E. Wolter, MD, MSc

    Otolaryngologist
    Hospital for Sick Children
    Toronto, Ontario, Canada

    Disclosure information not submitted.