Abstract:
Background:
Hemangiomas are the most common soft-tissue tumors affecting neonates and rarely lead to complications.
Objectives:
Assess cost-effectiveness of management of infantile hemangiomas via Telehealth (TH) versus in-person (IP) visits.
Methods:
Patients with vascular anomalies were assumed to be in 1 of 3 states: infantile hemangioma, non-serious condition, or serious condition. Decision models were constructed for initial and long-term cost of care for patients with infantile hemangiomas. Management was defined as initial visit at 3 months of age with follow-up visits every 3 months until 15 months of age. Reimbursement values were extracted from Medicare data and economic estimates of indirect costs. The expected value of patient visits were calculated in the model, and the lower expected cost was considered optimal. Expected values were calculated under two perspectives: a patient/payer perspective and a “societal” (patient/payer/provider) perspective, the former assuming TH and IP visits would be equally reimbursed, and the latter incorporating the estimated cost saving arising from lower overhead costs. Deterministic sensitivity analysis was conducted to assess the most salient model inputs.
Results:
After accounting for increased risk of misdiagnosis and serious conditions, from a patient (payer) perspective, TH was associated with $10.26 cost savings for the initial visit. From societal perspective TH saved $55.26 Thus, in comparison to IP, TH is associated with 3.89% and 18.01% cost savings from the payer and societal perspectives, respectively.
Conclusion:
The use of TH for initial and complete management infantile hemangioma proved to be cost-effective from both a payer/patient and societal perspective.
Biography:
Christopher Snyder, MD, is a pediatric cardiologist at UH Rainbow Babies & Children’s Hospital. He joined the UH Rainbow medical staff eight years ago and has served in a number of roles during that time, including Head of Electrophysiology and Executive Committee Member for the hospital. In addition, he is the former KeyBank-Meyer Family Chair for Excellence in Leadership and has previously served as faculty at Yale-New Haven School of Medicine and Ochsner Clinic Foundation.
Dr. Snyder is a graduate of Wayne State University School of Medicine and Baylor College of Medicine. He completed a residency and fellowship at Texas Children’s Hospital with sub-specialty training in pediatric and adult congenital electrophysiology.
With more than 90 peer-reviewed articles and more than 10 book chapters, Dr. Snyder has presented his research at all the major pediatric cardiac meetings in the United States and throughout the world. He is a member of the American Academy of Pediatrics, Heart Rhythm Society, the American College of Cardiology and the American Heart Association. He currently serves as Chair of the Section of Cardiology and Cardiovascular Surgery for the American Academy of Pediatrics and as Chair of the Joint Counsel on Congenital Heart Disease.
During his career, Dr. Snyder has been a member of the Alpha Omega Alpha Honor Medical Society, has been recognized as a Cleveland Best Doctor for the past 8 years and as a Castle Connelly Outstanding Physician. He also received the AAP Recognition of Distinguished Service Award.
He currently serves as a senior editor for Congenital Heart Disease and Case Reports in Cardiology, and editor for the American Journal of Cardiology, The Scientific Pages in Pediatrics and the Journal of Pediatrics and Child Care. He also performs reviews for the PACE, Journal of Invasive Electrophysiology and Pediatrics.
