Cost-Benefit Analysis of an Otolaryngology Emergency Room Using a Contingent Valuation Approach. (October 2015)

• Record Type: Journal Article
• Authors: Naunheim, Matthew R.; Kozin, Elliot D.; Sethi, Rosh K.; Ota, H. Gregory; Gray, Stacey T.; Shrime, Mark G.
• Is Part Of: Otolaryngology--head and neck surgery. Volume 153:Number 4(2015:Oct.)
• Page Start: 575
• Page End: 581
• Publication Date: 2015-10
• Subjects: cost-benefit analysis -- contingent valuation -- willingness to pay -- emergency services -- specialty emergency rooms; Head -- Surgery -- Periodicals; Neck -- Surgery -- Periodicals; Otolaryngology -- Periodicals; 617.51
• DOI: 10.1177/0194599815596742
• Languages: English
• ISSNs: 0194-5998

Abstract

Objectives: Dedicated otolaryngology emergency rooms (ERs) provide a unique mechanism of health care delivery. Relative costs and willingness to pay (WTP) for these services have not been studied. This study aims to provide a cost-benefit analysis of otolaryngology-specific ER care. Study Design: Cost-benefit analysis based on contingent valuation surveys. Setting: An otolaryngology-specific ER in a tertiary care academic medical center. Subjects and Methods: Adult English-speaking patients presenting to an otolaryngology ER were included. WTP questions were used to assess patient valuations of specialty emergency care. Sociodemographic data, income, and self-reported levels of distress were assessed. State-level and institution-specific historical cost data were merged with WTP data within a cost-benefit analysis framework. Results: The response rate was 75.6%, and 199 patients were included in the final analysis. Average WTP for otolaryngology ER services was $319 greater than for a general ER (95% CI: $261 to $377), with a median value of $200. The historical mean cost per visit at a general ER was $575, and mean cost at the specialty ER was $551 (95% CI: $529 to $574). Subtracting incremental cost from incremental WTP yielded a net benefit of $343. Conclusion: Dedicated otolaryngology ER services are valued by patients for acute otolaryngologic problems and have a net benefit of $343 per patient visit. They appear to be a cost-beneficial method for addressing acute otolaryngologic conditions. This study has implications for ER-based otolaryngologic care and direct-to-specialist services.