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  • Assessment of Cost Drivers for Open Microsurgery or Stereotactic Radiosurgery for Intracranial Meningiomas

    Final Number:
    1542

    Authors:
    Mohammed Azab; Hussam Abou Al-Shaar MD; Michael Karsy MD PhD; Jian Guan MD; Randy L. Jensen MD; William T. Couldwell MD, PhD

    Study Design:
    Other

    Subject Category:

    Meeting: Congress of Neurological Surgeons 2018 Annual Meeting

    Introduction: Understanding the costs of open surgical or radiosurgical treatment of intracranial meningioma, can be potentially performed using the Value Driven Outcome (VDO) database, which identifies true care cost over time.

    Methods: We retrospectively performed a cohort study of cost drivers and clinical characteristics patients undergoing microsurgical or radiosurgical treatment of intracranial meningiomas from July 2011 to April 2017.

    Results: Of the 268 intracranial meningiomas treated, 198 were managed microsurgically and 70 with stereotactic radiosurgery (SRS). While no difference in patient age (p=0.2) or size (p=0.07) was observed, there were differences in tumor location (p=0.0001) and gender (p=0.03) suggesting different indications between open surgery and SRS. Facility costs were the most significant contributor to the total costs in the microsurgical group (59.7%), whereas imaging costs were the most significant contributor to the costs in the SRS group (98.2%). Multivariate analysis for the open surgical group showed that LOS and maximal tumor size contributed significantly to the total costs, whereas age was a significant cost contributor to the total costs for radiosurgery group (p<0.05).

    Conclusions: Facility utilization and imaging costs constitute the majority of total costs in intracranial meningioma treatment strategies. Protocols to reduce facility and imaging costs should be developed and implemented to mitigate the total costs, improve resource utilization, and maintain high-quality patient care. Additional cost-effectiveness studies evaluating patients with true therapeutic equipoise are required to better appreciate which treatment modality can be better for patients.

    Patient Care: This work will improve understanding of treatment costs for patients with meningiomas, which should be more frequently considered during the overall course of clinical care.

    Learning Objectives: By the conclusion of this session, participants should be able to: 1) Describe the differences in cost drivers for the treatment of meningiomas by surgery or radiosurgery

    References:

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