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Swallowed Foreign Objects Cost $2M at RI Hospital

John Commins, for HealthLeaders Media, November 3, 2010

A Rhode Island Hospital report shows that 33 patients needed 305 medical interventions to remove foreign objects, including knives, razor blades, and batteries that were intentionally swallowed, resulting in more than $2 million in hospital costs over eight years.

The findings appear in the November issue of Clinical Gastroenterology and Hepatology.

Through a retrospective case study, the most common items were pens (24%), batteries (9%), knives (7%) and razor blades (7%). Most of the removals were successful during the initial endoscopic extraction except for 20 cases. Two cases eventually required a surgical extraction. The 305 cases involved 33 patients, of which 79% were previously diagnosed with a psychiatric disorder.

"Intentional foreign body ingestion occurs among a relatively small number of patients with psychiatric disorders and is costly," says Steven Moss, MD, in a statement.  Moss is a gastroenterologist at RIH, and lead author of the study. "While endoscopic retrieval is relatively safe and effective, it often requires general anesthesia and utilizes significant hospitals resources."

In 237 cases, the foreign objects were retrieved most commonly from the stomach or esophagus. Complications arose in 10 cases and surgical consultations were required. There were no cases of perforations or patient deaths. Hospital costs incurred in the patients' care from these 305 cases totaled $2,018,073, paid primarily by Medicare/Medicaid. The biggest cost drivers were nursing care (56%), followed by endoscopy, emergency department, and surgical services.

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