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National treatment trends, complications, and predictors of in-hospital charges for the surgical management of craniopharyngiomas in adults from 2007 to 2011.
- Source :
-
Neurosurgical focus [Neurosurg Focus] 2014 Nov; Vol. 37 (5), pp. E6. - Publication Year :
- 2014
-
Abstract
- Object: Treatment of craniopharyngiomas is one of the most demanding and controversial neurosurgical procedures performed. The authors sought to determine the factors associated with hospital charges and fees for craniopharyngioma treatment to identify possible opportunities for improving the health care economics of inpatient care.<br />Methods: The authors analyzed the hospital discharge database of the Nationwide Inpatient Sample (NIS) covering the period from 2007 through 2011 to examine national treatment trends for adults (that is, those older than 18 years) who had undergone surgery for craniopharyngioma. To predict the drivers of in-hospital charges, a multistep regression model was developed that accounted for patient demographics, acuity measures, comorbidities, hospital characteristics, and complications.<br />Results: The analysis included 606 patients who underwent resection of craniopharyngioma; 353 resections involved a transsphenoidal approach (58%) and 253 a transfrontal approach (42%). The mean age (± SD) of patients was 47.7 ± 16.3 years. The average hospital length of stay (LOS) was 7.6 ± 9 days. The mean hospital charge (± SD) was $92,300 ± $83,356. In total, 48% of the patients experienced postoperative diabetes insipidus or an electrolyte abnormality. A multivariate regression model demonstrated that LOS, hospital volume for the selected procedure, the surgical approach, postoperative complications, comorbidities, and year of surgery were all significant predictors of in-hospital charges. The statistical model accounted for 54% of the variance in in-hospital charge.<br />Conclusions: This analysis of inpatient hospital charges in patients undergoing craniopharyngioma surgery identified key drivers of charges in the perioperative period. Prospective studies designed to evaluate the long-term resource utilization in this complex patient population would be a useful future direction.
- Subjects :
- Adult
Aged
Databases, Factual
Female
Hospitalization economics
Hospitalization statistics & numerical data
Humans
Male
Middle Aged
Neurosurgical Procedures adverse effects
Retrospective Studies
Treatment Outcome
United States
Craniopharyngioma economics
Craniopharyngioma surgery
Hospital Charges statistics & numerical data
Neurosurgical Procedures economics
Pituitary Neoplasms economics
Pituitary Neoplasms surgery
Subjects
Details
- Language :
- English
- ISSN :
- 1092-0684
- Volume :
- 37
- Issue :
- 5
- Database :
- MEDLINE
- Journal :
- Neurosurgical focus
- Publication Type :
- Academic Journal
- Accession number :
- 25363434
- Full Text :
- https://doi.org/10.3171/2014.8.FOCUS14366