Interdisciplinary Pediatric Aerodigestive Care and Reduction in Health Care Costs and Burden

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Abstract
Children with complex respiratory and gastrointestinal symptoms, also known as aerodigestive disorders, can present with a variety of diagnoses, including sleep apnea, asthma, congenital airway or esophageal anomalies, dysphagia, feeding disorders, gastroesophageal reflux, esophagitis, and/or airway malacia. The burden of disease is unknown because no estimates of the prevalence of these complex aerodigestive disorders exist, but these conditions may be more common than previously realized. One common presentation of a pediatric aerodigestive disorder is infant feeding disorder: in 2010 2.6% of sick newborns discharged from short hospital stays in the United States had feeding disorders (International Classification of Diseases, Ninth Revision [ICD-9] code 779.3).1 These disorders, even as comorbidities, can lead to increased mortality and morbidity; for example, comorbid dysphagia in hospitalized patients has been associated with longer hospital stays and increased mortality.2 These children frequently require care from multiple pediatric subspecialists, including gastroenterologists, dietitians and/or nutritionists, otolaryngologists, pulmonologists, respiratory therapists, and speech-language pathologists. Over the past decade, a number of pediatric tertiary care hospitals have established interdisciplinary clinics to coordinate care,3,4 including at least 35 centers in the United States as of May 2014 (found via systematic web search for pediatric aerodigestive center websites, May 16, 2014).

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