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 |  | With Health Insurance: Copays + 10%-50% Coinsurance |  | Without Health Insurance: $10,000-$150,000+ |
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A tracheotomy, also called a tracheostomy, is an operation to create a hole through the neck and windpipe, to insert a tube to allow breathing and/or removal of lung secretions. It can be temporary or permanent and is performed for a variety of reasons, including: airway blockage, trauma, neck cancer and inhalation of harmful substances. Risks include reaction to anesthesia, bleeding, infection, scarring, damage to the nerves, esophagus or windpipe, narrowing of the airway and death.
Typical costs: | - A tracheostomy typically is covered by health insurance. For patients covered by health insurance, typical out-of-pocket costs consist of doctor visit copays, hospital admission copays and coinsurance of 10%-50%, possibly reaching the out-of-pocket maximum in complicated cases.
- For patients without health insurance, a tracheostomy and associated hospital stay typically costs about $10,000-$150,000 or more, depending on the reason for the tracheostomy, the underlying medical condition, complications, the amount of time required on a ventilator and the length of hospital stay.
- The actual tracheostomy procedure makes up a small portion of total costs; for example, one study[1] , by the Division of Otolaryngology-Head and Neck Surgery, Department of Surgery, University of Rochester Medical Center, showed average hospital charges for an open tracheostomy in the operating room to be about $1,690 including operating room time, surgeon fee, anesthesia and supplies, while charges for a bedside percutaneous tracheostomy were about $235.
- A bedside percutaneous tracheostomy involves using a special needle to create the hole, then dilating the opening to fit the tracheostomy tube; it costs less because it does not require an operating room and the procedure is simpler and takes less time than open surgery. However, subsequent hospital stays and care can add thousands or tens of thousands of dollars to the total cost. For example, at Saint Elizabeth Regional Medical Center[2] in Nebraska charges about $7,900 for a tracheostomy and subsequent hospital stay, not including doctor fee. And Baptist Memorial Healthcare in Memphis charges about $26,300, not including the doctor fees; however with complications, costs at that hospital can reach $85,000 or more.
- In one recent National Institutes of Health study[3] , average hospital charges were about $123,000 with a percutaneous tracheostomy and about $156,000 with an open tracheostomy. According to the Agency for Healthcare Research and Quality[4] , a tracheostomy itself is not inherently expensive, but is often associated with costly hospital stays because it is often performed on seriously ill individuals who require extended stays with intensive care.
Related articles: Anesthesia, Emergency Room Visit, Ambulance, Health Insurance
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What should be included: | - In an open tracheostomy in the operating room, the patient is placed under general anesthesia and the surgeon cuts through the neck and trachea to create a hole, then inserts a tracheostomy tube. The National Institutes of Health offers an overview[5] of an open tracheostomy.
- In a percutaneous tracheostomy, which can be done at the patient's bedside with monitoring, open surgery is not required; instead, the trachea is punctured with a special needle, then dilated until a tracheostomy tube can be inserted. JohnsHopkinsMedicine.org has an overview[6] of percutaneous tracheostomy.
- A hospital stay of three to 10 days -- but usually fewer than five -- typically is required. The patient typically cannot speak and must be fed with a feeding tube at first. Depending on other underlying factors and complications, weeks or even months of hospitalization could be required.
Additional costs: | - Unless the tracheostomy is reversed before the patient leaves the hospital -- which will depend on the reason it was performed -- the patient will need to purchase home tracheostomy care equipment and supplies that can cost thousands or tens of thousands of dollars, depending on which equipment is needed. JohnsHopkinsMedicine.org offers an overview of necessary items[7] . At BPI Medical Supply[8] , a stationary suction machine costs about $250, disposable tracheostomy care kits cost about $60 for a case of 30, disposable trachea tube holders cost about $40 for a box of 10. At Specialty Medical Supply[9] , tracheostomy masks cost about $23 for a pack of five, and a portable suction machine costs about $285.
Discounts: | - Many doctors and hospitals give discounts of up to 30% or more to uninsured/cash-paying patients. For example, Washington Hospital Healthcare System[10] in California offers a 35% discount.
Shopping for a tracheostomy: | - A family doctor can make a referral to an otolaryngologist -- a head and neck surgeon. The American Academy of Otolaryngology offers a doctor finder[11] by zip code. The surgeon should be board-certified by the American Board of Otolaryngology.
- Questions to ask the surgeon include what type of tracheostomy is being recommended -- open or percutaneous -- and why, and what type of tracheostomy tube[12] is recommended.
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Material on this page is for informational purposes only and should not be construed as medical advice. Always consult your physician or pharmacist regarding medications or medical procedures.
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External Resources: | - www.tracheostomy.com/resources/articles/bedside_trach/index.htm
- tp.chi.acelogicus.net/nese/Default.aspx
- www.ncbi.nlm.nih.gov/pubmed/19130311
- www.ahrq.gov/data/hcup/factbk7/factbk7b.htm
- www.nlm.nih.gov/medlineplus/ency/article/002955.htm
- www.hopkinsmedicine.org/tracheostomy/about/bedside.html
- www.hopkinsmedicine.org/tracheostomy/living/equipment.html
- www.bpimedicalsupply.com/CTGY/Trachea-Care.html
- www.specialtymedicalsupply.com/tracheostomy-masks.html
- www.whhs.com/about/washington-hospital-discount-policy-for-uninsured/
- www.entnet.org/
- www.hopkinsmedicine.org/tracheostomy/about/types.html
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