American Association for Hand Surgery
AAHS Home AAHS Home Past & Future Meetings Past & Future Meetings

Back to 2023 Abstracts


Costs of a Thumb: An Analysis of Pollicization Using the PHIS Database
Katherine Blaire Egan, MD1; Rachel M Danforth, MD1; Joshua M Adkinson, MD2; Khoa Dang Tran, BS1
1Indiana University, Indianapolis, IN; 2Indiana University School of Medicine, Indianapolis, IN

Costs of a Thumb: An Analysis of Pollicization Using the PHIS Database
Hypothesis: Pollicization is utilized to create a functional prehensile thumb in children with thumb hypoplasia. Whereas the functional benefits of pollicization are clear, costs of the procedure vary substantially and might be increasing over time. We sought to explore changes and trends in surgical charges for pediatric pollicization over time.
Methods: The Pediatric Health Information System (PHIS) was utilized to identify all patients who underwent pollicization (CPT code 26550) from 2010 to 2021. The total patient charges, length of hospital stay, payer source, median household income, and cases done per year (per hospital system) were collected. Kruskal-Wallis rank sum test, Pearsonís Chi-square test and an exploratory logistic regression were utilized to evaluate for correlation.
Results: 652 patients underwent pollicization during the study period. The most common diagnoses were: longitudinal deficiency, phalanges, complete or partial (27.8%), other reduction defects of right upper limb (10.6%), and Other reduction defects of left upper limb (8.6%).
The average median household income was ,844. The patients were classified as Ambulatory Surgery (45.1%), Observation Unit (42.9%), Inpatient (10.9%), and other/unknown (1.1%). After the procedure, most (96.9%) stayed in the hospital for only 1 day.
From 2010 to 2021, total charges increased. Total charges nearly doubled between 2010 and 2021, from ,100 to ,177. A substantial increase was also observed with the median charge (,057 to ,089) and minimum charge (,701 to ,285). The most common payors were Medicaid (46.9%) and commercial insurance (42.8%).
Hospitals that performed more than 5 pollicizations per year had lower overall patient costs than those that performed fewer.
Summary Points: Over the past decade, there has been a significant overall increase in charges for pediatric pollicization. Hospitals that perform more pollicizations had lower surgical charges. In order to minimize healthcare costs, a greater effort to regionalize care for this relatively rare procedure may be warranted.


Back to 2023 Abstracts