O-021 Hospitalization costs for endovascular and surgical treatment of unruptured cerebral aneurysms in the USA are substantially higher than medicare payments. (12th July 2011)

• Record Type: Journal Article
• Authors: Brinjikji, W; Kallmes, D; Lanzino, G; Cloft, H
• Is Part Of: Journal of neurointerventional surgery. Volume 3(2011)Supplement 1
• Page Start: A9
• Page End: A9
• Publication Date: 2011-07-12
• Subjects: Nervous system -- Surgery -- Periodicals; Cerebrovascular disease -- Surgery -- Periodicals; 617.48
• DOI: 10.1136/neurintsurg-2011-010097.21
• Languages: English
• ISSNs: 1759-8478

Abstract

Abstract : Background and Purpose: Endovascular and surgical options are both available for the treatment of unruptured cerebral aneurysms. Knowledge of the costs for hospitalization of these patients is important to understanding economic impact of these patients on hospitals. Methods: Using the National Inpatient Sample, hospitalizations for clipping and coiling of unruptured cerebral aneurysms from 2001 to 2008 were identified by cross-matching ICD-9 codes for diagnosis of unruptured aneurysm with procedure codes for clipping or coiling of cerebral aneurysms, and excluding all patients with diagnosis of subarachnoid hemorrhage and intracerebral hemorrhage. Hospital costs for 2008 were correlated with age, gender, and discharge status, and compared to Medicare payments. Results: Costs of both clipping and coiling have increased from 2001 to 2008. The median 2008 hospital costs were US$23 574 (IQR 18233–29941) for clipping and US$25 734 (IQR 17436–35846) for coiling without complication, which were higher than the average Medicare payment of US$12 599. The median hospital costs were US$36 188 (IQR 21831–55308) for clipping and US$40 502 (IQR 24289–50108) for coiling treatments complicated by major morbidity, and US$68 165 (IQR 32972–100211) for clipping and US$56 020 (IQR 00000–00000) for coiling treatments complicated by mortality, which were higher than the average Medicare payments for patients with major complications and comorbidities of US$22 946. In multivariate analysis, female gender was associated with higher costs for coiling (p=0.02), and poor discharge status was associated with higher costs for both clipping (p<0.001) and coiling (p<0.001). Conclusions: Hospitalization costs for patients undergoing clipping and coiling of unruptured cerebral aneurysms are substantially higher than Medicare payments.