Analysis of cost variation in craniotomy for tumor using 2 national databases

Corinna Zygourakis, Caterina Y. Liu, Seungwon Yoon, Christopher Moriates, Christy Boscardin, R. Adams Dudley, Michael T. Lawton, Philip Theodosopoulos, Mitchel S. Berger, Ralph Gonzales

Research output: Contribution to journalArticle

Abstract

Background: There is a significant increase and large variation in craniotomy costs. However, the causes of cost differences in craniotomies remain poorly understood. Objective: To examine the patient and hospital factors that underlie the cost variation in tumor craniotomies using 2 national databases: the National Inpatient Sample (NIS) and Vizient, Inc. (Irving, Texas). Methods: For 41 483 patients who underwent primary surgery for supratentorial brain tumors from 2001 to 2013 in the NIS, we created univariate and multivariate models to evaluate the effect of several patient factors and hospital factors on total hospital cost. Similarly, we performed multivariate analysis with 15 087 cases in the Vizient 2012 to 2015 database. Results: In the NIS, the mean inflation-adjusted cost per tumor craniotomy increased 30%, from $23 021 in 2001 to $29 971 in 2013. In 2001, the highest cost region was the Northeast ($24 486 ± $1184), and by 2013 the western United States was the highest cost region ($36 058 ± $1684). Multivariate analyses with NIS data showed that male gender, white race, private insurance, higher mortality risk, higher severity of illness, longer length of stay, elective admissions, higher wage index, urban teaching hospitals, and hospitals in the western United States were associated with higher tumor craniotomy costs (all P < .05). Multivariate analyses with Vizient data confirmed that longer length of stay and the western United States were significantly associated with higher costs (P< .001). Conclusion: After controlling for patient/clinical factors, hospital type, bed size, and wage index, hospitals in the western United States had higher costs than those in other parts of the country, based on analyses from 2 separate national databases.

Original languageEnglish (US)
Pages (from-to)972-979
Number of pages8
JournalClinical Neurosurgery
Volume81
Issue number6
DOIs
StatePublished - Dec 1 2017
Externally publishedYes

Fingerprint

Craniotomy
Databases
Costs and Cost Analysis
Neoplasms
Inpatients
Multivariate Analysis
Salaries and Fringe Benefits
Length of Stay
Hospital Bed Capacity
Supratentorial Neoplasms
Hospital Costs
Urban Hospitals
Economic Inflation
Insurance
Brain Neoplasms
Teaching Hospitals
Mortality

Keywords

  • Brain tumor
  • Cost of surgery
  • Cost variation
  • Craniotomy
  • Craniotomy for tumor
  • National Inpatient Sample (NIS) database
  • University health consortium (UHC)
  • Vizient

ASJC Scopus subject areas

  • Surgery
  • Clinical Neurology

Cite this

Zygourakis, C., Liu, C. Y., Yoon, S., Moriates, C., Boscardin, C., Adams Dudley, R., ... Gonzales, R. (2017). Analysis of cost variation in craniotomy for tumor using 2 national databases. Clinical Neurosurgery, 81(6), 972-979. https://doi.org/10.1093/neuros/nyx133

Analysis of cost variation in craniotomy for tumor using 2 national databases. / Zygourakis, Corinna; Liu, Caterina Y.; Yoon, Seungwon; Moriates, Christopher; Boscardin, Christy; Adams Dudley, R.; Lawton, Michael T.; Theodosopoulos, Philip; Berger, Mitchel S.; Gonzales, Ralph.

In: Clinical Neurosurgery, Vol. 81, No. 6, 01.12.2017, p. 972-979.

Research output: Contribution to journalArticle

Zygourakis, C, Liu, CY, Yoon, S, Moriates, C, Boscardin, C, Adams Dudley, R, Lawton, MT, Theodosopoulos, P, Berger, MS & Gonzales, R 2017, 'Analysis of cost variation in craniotomy for tumor using 2 national databases', Clinical Neurosurgery, vol. 81, no. 6, pp. 972-979. https://doi.org/10.1093/neuros/nyx133
Zygourakis C, Liu CY, Yoon S, Moriates C, Boscardin C, Adams Dudley R et al. Analysis of cost variation in craniotomy for tumor using 2 national databases. Clinical Neurosurgery. 2017 Dec 1;81(6):972-979. https://doi.org/10.1093/neuros/nyx133
Zygourakis, Corinna ; Liu, Caterina Y. ; Yoon, Seungwon ; Moriates, Christopher ; Boscardin, Christy ; Adams Dudley, R. ; Lawton, Michael T. ; Theodosopoulos, Philip ; Berger, Mitchel S. ; Gonzales, Ralph. / Analysis of cost variation in craniotomy for tumor using 2 national databases. In: Clinical Neurosurgery. 2017 ; Vol. 81, No. 6. pp. 972-979.
@article{4f11524abb5d48a5a83fbfc3f942402b,
title = "Analysis of cost variation in craniotomy for tumor using 2 national databases",
abstract = "Background: There is a significant increase and large variation in craniotomy costs. However, the causes of cost differences in craniotomies remain poorly understood. Objective: To examine the patient and hospital factors that underlie the cost variation in tumor craniotomies using 2 national databases: the National Inpatient Sample (NIS) and Vizient, Inc. (Irving, Texas). Methods: For 41 483 patients who underwent primary surgery for supratentorial brain tumors from 2001 to 2013 in the NIS, we created univariate and multivariate models to evaluate the effect of several patient factors and hospital factors on total hospital cost. Similarly, we performed multivariate analysis with 15 087 cases in the Vizient 2012 to 2015 database. Results: In the NIS, the mean inflation-adjusted cost per tumor craniotomy increased 30{\%}, from $23 021 in 2001 to $29 971 in 2013. In 2001, the highest cost region was the Northeast ($24 486 ± $1184), and by 2013 the western United States was the highest cost region ($36 058 ± $1684). Multivariate analyses with NIS data showed that male gender, white race, private insurance, higher mortality risk, higher severity of illness, longer length of stay, elective admissions, higher wage index, urban teaching hospitals, and hospitals in the western United States were associated with higher tumor craniotomy costs (all P < .05). Multivariate analyses with Vizient data confirmed that longer length of stay and the western United States were significantly associated with higher costs (P< .001). Conclusion: After controlling for patient/clinical factors, hospital type, bed size, and wage index, hospitals in the western United States had higher costs than those in other parts of the country, based on analyses from 2 separate national databases.",
keywords = "Brain tumor, Cost of surgery, Cost variation, Craniotomy, Craniotomy for tumor, National Inpatient Sample (NIS) database, University health consortium (UHC), Vizient",
author = "Corinna Zygourakis and Liu, {Caterina Y.} and Seungwon Yoon and Christopher Moriates and Christy Boscardin and {Adams Dudley}, R. and Lawton, {Michael T.} and Philip Theodosopoulos and Berger, {Mitchel S.} and Ralph Gonzales",
year = "2017",
month = "12",
day = "1",
doi = "10.1093/neuros/nyx133",
language = "English (US)",
volume = "81",
pages = "972--979",
journal = "Neurosurgery",
issn = "0148-396X",
publisher = "Lippincott Williams and Wilkins",
number = "6",

}

TY - JOUR

T1 - Analysis of cost variation in craniotomy for tumor using 2 national databases

AU - Zygourakis, Corinna

AU - Liu, Caterina Y.

AU - Yoon, Seungwon

AU - Moriates, Christopher

AU - Boscardin, Christy

AU - Adams Dudley, R.

AU - Lawton, Michael T.

AU - Theodosopoulos, Philip

AU - Berger, Mitchel S.

AU - Gonzales, Ralph

PY - 2017/12/1

Y1 - 2017/12/1

N2 - Background: There is a significant increase and large variation in craniotomy costs. However, the causes of cost differences in craniotomies remain poorly understood. Objective: To examine the patient and hospital factors that underlie the cost variation in tumor craniotomies using 2 national databases: the National Inpatient Sample (NIS) and Vizient, Inc. (Irving, Texas). Methods: For 41 483 patients who underwent primary surgery for supratentorial brain tumors from 2001 to 2013 in the NIS, we created univariate and multivariate models to evaluate the effect of several patient factors and hospital factors on total hospital cost. Similarly, we performed multivariate analysis with 15 087 cases in the Vizient 2012 to 2015 database. Results: In the NIS, the mean inflation-adjusted cost per tumor craniotomy increased 30%, from $23 021 in 2001 to $29 971 in 2013. In 2001, the highest cost region was the Northeast ($24 486 ± $1184), and by 2013 the western United States was the highest cost region ($36 058 ± $1684). Multivariate analyses with NIS data showed that male gender, white race, private insurance, higher mortality risk, higher severity of illness, longer length of stay, elective admissions, higher wage index, urban teaching hospitals, and hospitals in the western United States were associated with higher tumor craniotomy costs (all P < .05). Multivariate analyses with Vizient data confirmed that longer length of stay and the western United States were significantly associated with higher costs (P< .001). Conclusion: After controlling for patient/clinical factors, hospital type, bed size, and wage index, hospitals in the western United States had higher costs than those in other parts of the country, based on analyses from 2 separate national databases.

AB - Background: There is a significant increase and large variation in craniotomy costs. However, the causes of cost differences in craniotomies remain poorly understood. Objective: To examine the patient and hospital factors that underlie the cost variation in tumor craniotomies using 2 national databases: the National Inpatient Sample (NIS) and Vizient, Inc. (Irving, Texas). Methods: For 41 483 patients who underwent primary surgery for supratentorial brain tumors from 2001 to 2013 in the NIS, we created univariate and multivariate models to evaluate the effect of several patient factors and hospital factors on total hospital cost. Similarly, we performed multivariate analysis with 15 087 cases in the Vizient 2012 to 2015 database. Results: In the NIS, the mean inflation-adjusted cost per tumor craniotomy increased 30%, from $23 021 in 2001 to $29 971 in 2013. In 2001, the highest cost region was the Northeast ($24 486 ± $1184), and by 2013 the western United States was the highest cost region ($36 058 ± $1684). Multivariate analyses with NIS data showed that male gender, white race, private insurance, higher mortality risk, higher severity of illness, longer length of stay, elective admissions, higher wage index, urban teaching hospitals, and hospitals in the western United States were associated with higher tumor craniotomy costs (all P < .05). Multivariate analyses with Vizient data confirmed that longer length of stay and the western United States were significantly associated with higher costs (P< .001). Conclusion: After controlling for patient/clinical factors, hospital type, bed size, and wage index, hospitals in the western United States had higher costs than those in other parts of the country, based on analyses from 2 separate national databases.

KW - Brain tumor

KW - Cost of surgery

KW - Cost variation

KW - Craniotomy

KW - Craniotomy for tumor

KW - National Inpatient Sample (NIS) database

KW - University health consortium (UHC)

KW - Vizient

UR - http://www.scopus.com/inward/record.url?scp=85042151278&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=85042151278&partnerID=8YFLogxK

U2 - 10.1093/neuros/nyx133

DO - 10.1093/neuros/nyx133

M3 - Article

VL - 81

SP - 972

EP - 979

JO - Neurosurgery

JF - Neurosurgery

SN - 0148-396X

IS - 6

ER -