{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,11,27]],"date-time":"2025-11-27T16:14:38Z","timestamp":1764260078876,"version":"build-2065373602"},"reference-count":26,"publisher":"Wiley","issue":"5","license":[{"start":{"date-parts":[[2019,6,11]],"date-time":"2019-06-11T00:00:00Z","timestamp":1560211200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["aao-hnsfjournals.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Otolaryngol.--head neck surg."],"published-print":{"date-parts":[[2019,11]]},"abstract":"<jats:sec><jats:title>Objective<\/jats:title><jats:p>To identify costs and operative times for stapedotomy and evaluate factors influencing cost variation.<\/jats:p><\/jats:sec><jats:sec><jats:title>Study Design<\/jats:title><jats:p>Case series with cost analysis.<\/jats:p><\/jats:sec><jats:sec><jats:title>Setting<\/jats:title><jats:p>Multihospital network.<\/jats:p><\/jats:sec><jats:sec><jats:title>Subjects and Methods<\/jats:title><jats:p>A multihospital network\u2019s standardized activity\u2010based accounting system was used to determine costs and operative times of all patients undergoing stapedotomy from 2013 to 2017. Subjects with additional procedures were excluded. Correlations between variable factors and cost were calculated by Spearman correlation coefficients. Audiometric and cost data were compared with a Mann\u2010Whitney <jats:italic>U<\/jats:italic> test.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>The study cohort included 176 stapedotomies performed by 23 surgeons at 10 hospitals. Mean \u00b1 SD patient age was 44.3 \u00b1 17.4 years. Mean cut\u2010to\u2010close time was 61.1 \u00b1 23.55\u00a0minutes. Mean total encounter cost was $3542.14 \u00b1 $1258.78 (US dollars). Significant factors correlating with increased total encounter cost were surgical supply cost (<jats:italic>r<\/jats:italic> = 0.74, <jats:italic>P<\/jats:italic> &lt;. 0001) and cut\u2010to\u2010close time (<jats:italic>r<\/jats:italic> = 0.66, <jats:italic>P<\/jats:italic> &lt;. 0001). Laser utilization ($563.37 \u00b1 $407.41) was the highest\u2010cost surgical supply, with the carbon dioxide laser being significantly more costly than the potassium titanyl phosphate (KTP; $852.60 vs $230.55, <jats:italic>P<\/jats:italic> &lt;. 001). Additionally, the carbon dioxide laser was associated with a significantly higher mean total encounter cost than the KTP laser ($4645.43 vs $2903.00, <jats:italic>P<\/jats:italic> &lt;. 001) and cases where no laser was used ($4645.43 vs $2932.47, <jats:italic>P<\/jats:italic> &lt;. 001). There was no difference in mean total encounter cost between the KTP laser and cases of no laser use ($2903.00 vs $2932.47, <jats:italic>P<\/jats:italic> =. 75).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Significant cost variation exists in stapes surgery. Surgical supply cost, specifically laser use, may be associated with significantly increased costs. Reducing variation in costs while maintaining outcomes may improve health care value.<\/jats:p><\/jats:sec>","DOI":"10.1177\/0194599819855055","type":"journal-article","created":{"date-parts":[[2019,6,11]],"date-time":"2019-06-11T08:28:27Z","timestamp":1560241707000},"page":"835-841","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":13,"title":["Variations in Stapes Surgery Cost within a Multihospital Network"],"prefix":"10.1002","volume":"161","author":[{"given":"Geoffrey C.","family":"Casazza","sequence":"first","affiliation":[{"name":"Division of Otolaryngology\u2013Head and Neck Surgery University of Utah Salt Lake City Utah USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Andrew J.","family":"Thomas","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology\u2013Head and Neck Surgery Oregon Health Sciences University Portland Oregon 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