Predictors of Variation in Neurosurgical Supply Costs and Outcomes Across 4904 Surgeries at a Single Institution
Document Type
Article
Abstract
Background There is high variability in neurosurgical costs, and surgical supplies constitute a significant portion of cost. Anecdotally, surgeons use different supplies for various reasons, but there is little understanding of how supply choices affect outcomes. Our goal is to evaluate the effect of patient, procedural, and provider factors on supply cost and to determine if supply cost is associated with patient outcomes. Methods We obtained patient information (age, gender, payor, case mix index [CMI], body mass index, admission source), procedural data (procedure type, length, date), provider information (name, case volume), and total surgical supply cost for all inpatient neurosurgical procedures from 2013 to 2014 at our institution (n = 4904). We created mixed-effect models to examine the effect of each factor on surgical supply cost, 30-day readmission, and 30-day mortality. Results There was significant variation in surgical supply cost between and within procedure types. Older age, female gender, higher CMI, routine/elective admission, longer procedure, and larger surgeon volume were associated with higher surgical supply costs (P < 0.05). Routine/elective admission and higher surgeon volume were associated with lower readmission rates (odds ratio, 0.707, 0.998; P < 0.01). Change this sentence to: “Only patient factors of older age, male gender, private insurance, higher CMI, and emergency admission were associated with higher mortality (odds ratio, 1.029, 1.700, 1.692, 1.080, 2.809). There was no association between surgical supply cost and readmission or mortality (P = 0.307, 0.548). Conclusions A combination of patient, procedural, and provider factors underlie the significant variation in neurosurgical supply costs at our institution. Surgical supply costs are not correlated with 30-day readmission or mortality.
Publication Date
12-1-2016
Publication Title
World Neurosurgery
ISSN
18788750
E-ISSN
18788769
Volume
96
First Page
177
Last Page
183
PubMed ID
27613498
Digital Object Identifier (DOI)
10.1016/j.wneu.2016.08.121
Recommended Citation
Zygourakis, Corinna C.; Valencia, Victoria; Boscardin, Christy; Nayak, Rahul U.; Moriates, Christopher; Gonzales, Ralph; Theodosopoulos, Philip; and Lawton, Michael T., "Predictors of Variation in Neurosurgical Supply Costs and Outcomes Across 4904 Surgeries at a Single Institution" (2016). Neurosurgery. 1166.
https://scholar.barrowneuro.org/neurosurgery/1166