Bulletin of the Hospital for Joint Disease (2013) · 2013
Hospital cost analysis of neuromuscular scoliosis surgery.
СтатьяНазвание и аннотация: Перевод в очереди
Обработка статьи · этапы, ошибки и управление
Загрузка состояния…
Ошибки и ограничения
История · было → стало
Состояние обновляется каждые 5 секунд, пока блок открыт. Процент показывается только там, где известен объём работы. Пауза останавливает продолжение этапа; текущий запрос к источнику может завершиться.
Diefenbach Christopher, Ialenti Marc N, Lonner Baron S, Kamerlink Jonathan R, Verma Kushagra, Errico Thomas J
Аннотация
STUDY DESIGN: A retrospective review of 74 consecutive, surgical patients with neuromuscular scoliosis (NMS).
OBJECTIVE: This study evaluates the distribution of hospital and operating room costs incurred during surgical correction of NMS.
BACKGROUND DATA: Recent studies have demonstrated that surgical treatment improves both medical outcomes and the quality of life in patients with progressive NMS. Characterization of the costs incurred at the time of surgery and hospitalization will facilitate the identification of opportunities for cost reduction.
METHODS: Demographic data collected included gender, age, preoperative height, weight, and BMI. Major coronal curvatures and T5-T12 kyphosis were assessed from radiographs. Construct type and number of screws, hooks, and wires implanted were recorded. Surgical costs were calculated based on cost of surgical correction, hospital stay, and postoperative care.
RESULTS: Mean age was 15.8 ± 7.3 years; 57% were male. Comorbidities included cerebral palsy (28%) and familial dysautonomia (14%). The mean preoperative major curve magnitude was 60°; minor curve magnitude was 33°. Posterior approach (76%) and pedicle screws (75%) were predominantly utilized. The average length of hospitalization was 8 days (range: 3 to 47). There were six major complications (8%). The total surgical cost was $50,096 ± $23,998. The highest individual cost was for implants ($13,916; 24% of total costs). The second highest was inpatient room and ICU costs ($12,483; 22%); bone grafts were the third ($6,398; 11%). Increased major and minor structural curve, increased total (A/P) levels fused, and increased length of hospital stay predicted an increase in total cost.
CONCLUSIONS: Major contributors to cost in NMS surgery are implants, inpatient room and ICU costs, and bone grafts. Independent predictors of higher cost are the degree of major and minor structural curve, total number of A/P levels fused, and length of hospital stay. These conclusions provide insight into costs associated with care for a medically fragile and challenging patient population.
OBJECTIVE: This study evaluates the distribution of hospital and operating room costs incurred during surgical correction of NMS.
BACKGROUND DATA: Recent studies have demonstrated that surgical treatment improves both medical outcomes and the quality of life in patients with progressive NMS. Characterization of the costs incurred at the time of surgery and hospitalization will facilitate the identification of opportunities for cost reduction.
METHODS: Demographic data collected included gender, age, preoperative height, weight, and BMI. Major coronal curvatures and T5-T12 kyphosis were assessed from radiographs. Construct type and number of screws, hooks, and wires implanted were recorded. Surgical costs were calculated based on cost of surgical correction, hospital stay, and postoperative care.
RESULTS: Mean age was 15.8 ± 7.3 years; 57% were male. Comorbidities included cerebral palsy (28%) and familial dysautonomia (14%). The mean preoperative major curve magnitude was 60°; minor curve magnitude was 33°. Posterior approach (76%) and pedicle screws (75%) were predominantly utilized. The average length of hospitalization was 8 days (range: 3 to 47). There were six major complications (8%). The total surgical cost was $50,096 ± $23,998. The highest individual cost was for implants ($13,916; 24% of total costs). The second highest was inpatient room and ICU costs ($12,483; 22%); bone grafts were the third ($6,398; 11%). Increased major and minor structural curve, increased total (A/P) levels fused, and increased length of hospital stay predicted an increase in total cost.
CONCLUSIONS: Major contributors to cost in NMS surgery are implants, inpatient room and ICU costs, and bone grafts. Independent predictors of higher cost are the degree of major and minor structural curve, total number of A/P levels fused, and length of hospital stay. These conclusions provide insight into costs associated with care for a medically fragile and challenging patient population.
Предметные рубрики MeSH
AdolescentAdultBone TransplantationChildCost SavingsCost-Benefit AnalysisCritical CareFemaleHospital CostsHumansLength of StayMaleOperating RoomsOrthopedic ProceduresPostoperative CareProsthesis ImplantationQuality of LifeRetrospective StudiesScoliosisSpinal FusionTime FactorsTreatment OutcomeYoung Adult