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Program Number: B073
Session Name: Poster Session

Economic Impact of Home Drain Removal in a Head and Neck Surgery Clinic

Taylor E Freeman, MD¹; Katherine Weals, PAC²; Amanda Selhorst, PAC²; Kelly Vala, APRN, CNP²; Laura Skoracki, PAC²; Megan Adelman, PAC²; Jordyn Warren, APRN, CNP²; Sharon Cain, PAC²; Kathleen Bellamy³; Cindy Alban³; Rishabh Sethia, MD⁴; Kyle Vankoevering, MD¹; Ricardo Carrau, MD¹; Stephen Kang, MD¹; Amit Agrawal, MD¹; Enver Ozer, MD¹; Lauren Miller, MD, MBA¹; Catherine Haring, MD¹; James Rocco, MD, PhD¹; Matthew Old, MD¹; Nolan Seim, MD, MBA¹; ¹Department of Otolaryngology-Head and Neck Surgery, The Ohio State University Wexner Medical Center; ²Division of Head and Neck Oncology and Microvascular Reconstructive Surgery, The James Cancer Hospital and Solove Research Institute; ³The Ohio State University Wexner Medical Center; ⁴Department of Otolaryngology, Nationwide Children's Hospital

Background: Home drain removal has transformed peri-operative patient care, offering a safe and cost-effective option for patients and their families. However, little has been studied regarding the outcomes from a provider and institutional perspective. This study sought to evaluate the economic impact of home drain removal within a head and neck surgery clinic. 

Methods: The study population included patients who underwent head and neck surgery at an academic tertiary care center between February 2020 and October 2024 and were discharged home with surgical drains intended for home removal. Prior to discharge, patients received thorough drain removal education. Patients were prospectively followed to evaluate for associated outcomes including if drains were successfully removed at home and any associated complications. The average cost of new and established patient clinic visits as well as the cost of an advanced practice provider (APP) per hour were used to calculate cost estimates.

Results: 454 patients (61% men and 39% women) were evaluated in the study. 98.5% of patients received education at discharge including in person, written, or video instructions. Of the patients discharged home, 93.4% were able to successfully remove their drains at home resulting in 424 opened appointment slots, available to new or established patients. This offered the opportunity to generate an additional $86-$131 per available appointment depending on encounter type. Over the length of this study, the potential revenue creation ranged from $36,464-$55,544. This estimate did not include later payments for scheduled surgeries or procedures resulting from increased appointment availability. Additionally, home drain removal decreased the time in clinic for unpaid, post-operative visits seen by dedicated advanced practice providers. While cost savings are difficult to estimate, advanced practice providers earning $58-$75 dollars per hour, were able to utilize their skills and abilities for additional clinical duties. Of the 6.6% of patients who did not remove their drains at home, the majority lived close to the medical center and elected to have their drains removed in office following discharge.

Conclusion: The results demonstrate that home drain removal offers several benefits from a provider perspective including potential for cost savings, improved allocation of resources, and open clinic space for revenue generating encounters, ultimately creating a more cost-effective care model.

 

 

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