Costs of Sleep Endoscopy with Same-day versus Staged Surgery for Pediatric Obstructive Sleep Apnea

Saturday, October 11, 2025

9:48 AM - 9:54 AM EDT

Location: 233-234

Disclosure(s):

Nicholas R. Lenze, MD, MPH:

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

Erin M. Kirkham, MD MPH:

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

Introduction: There is little evidence to guide the decision on the timing of pediatric obstructive sleep apnea (OSA) surgery (same day versus staged) following drug-induced sleep endoscopy (DISE). Cost differences between surgical pathways could help guide this decision.

Methods: This was a retrospective cohort study of children who underwent DISE and OSA surgery at a single tertiary care center in the United States from 2017 to 2023. Patients were grouped into two surgical pathways: (1) DISE with same-day OSA surgery and (2) DISE with staged OSA surgery. Non-parametric tests and log-normal models were used to compare insurance payments, out-of-pocket costs, and hospital costs between pathways and to evaluate predictors of hospital cost.

Results: A total of 57 pediatric OSA patients with a mean (standard deviation [SD]) age of 10.8 (4.0) years were included. The mean insurance payments, out-of-pocket costs, and hospital costs were $12,158 (SD 10,412), $340 (SD 1,168), and $11,965 (SD 9,615), respectively. Patients who underwent DISE with staged OSA surgery had significantly higher hospital costs than those who underwent DISE with same-day OSA surgery (mean difference $8,995, 95% CI 3528 to 14462; p< 0.001), and this effect persisted in a log-normal model (coefficient 0.75, 95% CI 0.41 to 1.09; p< 0.001). There were no significant differences in insurance payments or out-of-pocket costs by surgical pathway.

Conclusions: DISE with staged OSA surgery conferred higher hospital costs than DISE with same-day OSA surgery but did not increase the financial burden on patients or payers. This finding has important implications for resource utilization for a common pediatric condition.

Presenting Author(s)

Nicholas R. Lenze, MD, MPH

Dr.
University of Michigan
Ann Arbor, MI, United States

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

Co-Author(s)

MA

Michael Allevato, PhD

University of Michigan, United States

Disclosure information not submitted.
WB

William John Benjamin, MD, MPH

Resident
Massachusetts Eye and Ear Infirmary
Boston, MA, United States

Disclosure information not submitted.
ES

Emmanuel Servin, BS

University of Michigan, United States

Disclosure information not submitted.
Erin M. Kirkham, MD MPH

Associate Professor, Otolaryngology
University of Michigan
ANN ARBOR, MI, United States

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

David A. Zopf, MD, MS

Associate Professor
University of Michigan
Ann Arbor, MI, United States

Disclosure information not submitted.

Senior Author(s)

JS

Joseph G. Sinnwell, MD

Academic Faculty
Wake Forest University School of Medicine
Winston-Salem, NC, United States

Disclosure information not submitted.