{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,2]],"date-time":"2026-05-02T15:50:51Z","timestamp":1777737051845,"version":"3.51.4"},"reference-count":16,"publisher":"SAGE Publications","issue":"1","license":[{"start":{"date-parts":[[2025,1,1]],"date-time":"2025-01-01T00:00:00Z","timestamp":1735689600000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Innovations&amp;#65533;(Phila)"],"published-print":{"date-parts":[[2025,1]]},"abstract":"<jats:sec>\n                    <jats:title>Objective:<\/jats:title>\n                    <jats:p>The purpose of this study was to assess the 5-year impact of a per oral endoscopic myotomy (POEM) program on both clinical and financial outcomes for our hospital system and the rural community we serve.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods:<\/jats:title>\n                    <jats:p>We evaluated the clinical and financial outcomes of all patients who underwent POEM for achalasia. Patients were also contacted by phone to complete the Gastroesophageal Reflux Disease-Health Related Quality of Life (GERD-HRQL) questionnaire postoperatively. Financial data for all robot-assisted laparoscopic Heller myotomy patients from our institution during the same period were also obtained for cost comparison.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>A total of 107 patients underwent POEM in the first 5 years following program implementation, with a mean age of 61.4 \u00b1 17.9 years. There were 75 patients (70%) who participated in the GERD-HRQL survey at a mean follow-up of 84 weeks (range, 6 to 244 weeks). There were 88.2% of respondents who reported no or minimal dysphagia symptoms, and 93.4% of respondents reported no or minimal reflux symptoms. On postoperative upper endoscopy, 19.1% of patients had esophagitis. Implementation of the POEM program resulted in a substantial increase in case volume, growing from 5 myotomy cases per year to 24 myotomy cases per year after 2017. Cost analysis demonstrated a significantly lower index encounter cost for POEM compared with robot-assisted laparoscopic Heller myotomy of approximately $6,000.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions:<\/jats:title>\n                    <jats:p>This study demonstrates the effectiveness and positive financial impact for both our community and hospital system following implementation of a POEM program at a tertiary medical center serving a large, rural population.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/15569845241300256","type":"journal-article","created":{"date-parts":[[2025,1,17]],"date-time":"2025-01-17T06:07:59Z","timestamp":1737094079000},"page":"27-32","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":0,"title":["Clinical Outcomes and Financial Impact of a POEM Program at a Rural Tertiary Medical Center: Our First Five Years"],"prefix":"10.1177","volume":"20","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-4358-8273","authenticated-orcid":false,"given":"Joseph","family":"Bethea","sequence":"first","affiliation":[{"name":"Department of General Surgery, East Carolina University, Greenville, NC, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Brandon","family":"Peine","sequence":"additional","affiliation":[{"name":"Department of General Surgery, East Carolina University, Greenville, NC, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0009-0006-7663-9726","authenticated-orcid":false,"given":"Tyler","family":"Fleming","sequence":"additional","affiliation":[{"name":"Department of General Surgery, East Carolina University, Greenville, NC, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jesse","family":"Mendes","sequence":"additional","affiliation":[{"name":"Department of General Surgery, East Carolina University, Greenville, NC, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Olajide","family":"Olatidoye","sequence":"additional","affiliation":[{"name":"Department of General Surgery, East Carolina University, Greenville, NC, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Robert","family":"Allman","sequence":"additional","affiliation":[{"name":"Division of Thoracic Surgery, Department of Cardiovascular Sciences, East Carolina University, Greenville, NC, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Aundrea","family":"Oliver","sequence":"additional","affiliation":[{"name":"Division of Thoracic Surgery, Department of Cardiovascular Sciences, East Carolina University, Greenville, NC, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mark","family":"Iannettoni","sequence":"additional","affiliation":[{"name":"Division of Thoracic Surgery, Department of Cardiovascular Sciences, East Carolina University, Greenville, NC, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"James","family":"Speicher","sequence":"additional","affiliation":[{"name":"Division of Thoracic Surgery, Department of Cardiovascular Sciences, East Carolina University, Greenville, NC, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Carlos","family":"Anciano","sequence":"additional","affiliation":[{"name":"Division of Thoracic Surgery, Department of Cardiovascular Sciences, East Carolina University, Greenville, NC, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"179","published-online":{"date-parts":[[2025,1,17]]},"reference":[{"key":"e_1_3_3_2_2","volume-title":"Current surgical therapy","author":"Cameron JL","year":"2023","unstructured":"Cameron JL, and Cameron AM (eds). Current surgical therapy. 14th ed. Philadelphia: Elsevier, 2023.","edition":"14"},{"key":"e_1_3_3_3_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.gie.2013.03.1335"},{"key":"e_1_3_3_4_2","doi-asserted-by":"publisher","DOI":"10.1007\/s00464-016-5217-y"},{"key":"e_1_3_3_5_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jamcollsurg.2015.03.057"},{"key":"e_1_3_3_6_2","doi-asserted-by":"publisher","DOI":"10.1097\/SLA.0000000000004830"},{"key":"e_1_3_3_7_2","doi-asserted-by":"publisher","DOI":"10.1007\/s00464-020-08031-3"},{"key":"e_1_3_3_8_2","doi-asserted-by":"publisher","DOI":"10.1097\/SLA.0000000000002311"},{"key":"e_1_3_3_9_2","doi-asserted-by":"publisher","DOI":"10.21037\/jtd.2016.09.39"},{"key":"e_1_3_3_10_2","doi-asserted-by":"publisher","DOI":"10.1007\/s10620-019-05784-3"},{"key":"e_1_3_3_11_2","doi-asserted-by":"publisher","DOI":"10.1055\/a-1133-4354"},{"key":"e_1_3_3_12_2","first-page":"270","article-title":"Climate change and public health through the lens of rural, Eastern North Carolina","volume":"79","author":"Kearney GD","year":"2018","unstructured":"Kearney GD, Jones K, Bell RA, et al. Climate change and public health through the lens of rural, Eastern North Carolina. N C Med J 2018; 79: 270\u2013277.","journal-title":"N C Med J"},{"key":"e_1_3_3_13_2","doi-asserted-by":"publisher","DOI":"10.1007\/s10900-022-01106-3"},{"key":"e_1_3_3_14_2","doi-asserted-by":"publisher","DOI":"10.1007\/s00464-020-07775-2"},{"key":"e_1_3_3_15_2","doi-asserted-by":"publisher","DOI":"10.1111\/j.1442-2050.2007.00658.x"},{"key":"e_1_3_3_16_2","doi-asserted-by":"publisher","DOI":"10.1007\/s11605-019-04264-3"},{"key":"e_1_3_3_17_2","unstructured":"Centers for Medicare & Medicaid Services. Billing and Coding: Peroral Endoscopic Myotomy (POEM) CMS Medicare Coverage Database https:\/\/www.cms.gov\/medicare-coverage-database\/view\/article.aspx?articleId=58287 (2023 accessed 26 May 2023)."}],"container-title":["Innovations: Technology and Techniques in Cardiothoracic and Vascular Surgery"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/15569845241300256","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/full-xml\/10.1177\/15569845241300256","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/15569845241300256","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,4,29]],"date-time":"2026-04-29T11:18:20Z","timestamp":1777461500000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.sagepub.com\/doi\/10.1177\/15569845241300256"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,1]]},"references-count":16,"journal-issue":{"issue":"1","published-print":{"date-parts":[[2025,1]]}},"alternative-id":["10.1177\/15569845241300256"],"URL":"https:\/\/doi.org\/10.1177\/15569845241300256","relation":{},"ISSN":["1556-9845","1559-0879"],"issn-type":[{"value":"1556-9845","type":"print"},{"value":"1559-0879","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,1]]}}}