Volume 1 ; Issue 1 ; in Month : Jan-June (2020) Article No : 101
Dudsdeemaytha P, Rodchareon P, Setabutr D.

Abstract
Objective: To review pediatric tracheostomy practices in a middle-income country at a resource limited hospital. Methods: We conducted a two-part study reviewing pediatric tracheostomy practice at a Thai tertiary academic center. Patients aged under eighteen who underwent a tracheostomy at Thammasat University Hospital (TUH) between January 2010 to September of 2019 were reviewed. Secondly, a cost analysis was done to review the financial implication from transitioning tracheostomy tube changes in the operating room suite to the outpatient clinic. Additionally, we review our Department’s process with transitioning to this modality. Results: Twenty-four patients underwent tracheostomy at TUH during the study time frame. The mean total cost of tracheostomy tube changes for inpatient (n=19) and outpatient cases (n=4) were 47,603.59 THB (1586.79 USD) and 787.38 THB (26.25 USD) respectively. There was a near-19-fold reduction in tracheostomy tube change costs when performed in the outpatient clinic. Conclusion: Pediatric tracheostomy changes in the outpatient clinic is a safe, cost-saving, modality in the developing world. The long-term financial benefit from transitioning from an inpatient to outpatient setting for pediatric tracheostomy change is promising.

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