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  • Evaluation of Annual Temporal Trends in Costs and Out-of-pocket Expenses of Transsphenoidal Pituitary Surgery in the United States

    Final Number:

    Anthony O Asemota MD MPH; Masaru Ishii MD; Henry Brem MD; Gary L. Gallia MD

    Study Design:

    Subject Category:

    Meeting: Congress of Neurological Surgeons 2018 Annual Meeting

    Introduction: Increased attention has been devoted to the need for improved efficiency in health care delivery systems, through optimizing value and patient outcomes while at the same time reducing costs. Till date, no study nationwide in scope has examined temporal trends in direct-costs of transsphenoidal pituitary surgery.

    Methods: Truven-Marketscan 2010-2014 database was accessed and trends in costs of transsphenoidal pituitary surgery were analyzed. Standard descriptive techniques and linear regression were used to analyze costs trends over time.

    Results: Overall, the mean total payment associated with transsphenoidal pituitary surgery hospitalization was $34,943.13 [SD±19,074.54]. Among these total costs, mean hospital/facility payment was $26,505.93 [SD±16,819.52], mean physician payment was 4,549.24 [SD±3,956.27], while the mean out-of-pocket expenses for patients undergoing transsphenoidal pituitary surgery were $2,262.40 [SD±4,903.76]. Annual trends in costs associated with transsphenoidal pituitary surgery showed an increase in overall total costs per case from $32,415.73 in 2010 to $37,942.27 in 2014, an approximate increase of 17.05% (p<0.001). As hospital/facility costs accounted for 75.85% of overall total costs, it was not surprising that hospital/facility costs also significantly increased during this period from baseline of $23,943.15 in 2010 to $29,403.32 in 2014 representing an increase of approximately 22.80% (p<0.001). Notably, the change in physician payments from $4,546.45 in 2010 to $4,445.11 in 2014 was not significant (p=0.56), and there were no significant differences in out-of-pocket expenses associated with transsphenoidal pituitary surgery during this time (from $2,355.49 in 2010 to $2,618.66 in 2014, p=0.27)

    Conclusions: Our results indicate increasing total costs of transsphenoidal pituitary surgery driven mostly by increasing hospital/facility costs. Given the widespread adoption and utilization of transsphenoidal techniques in pituitary surgery and the need to lower health-care costs, it is important for healthcare providers and policy makers to better understand factors underlying cost increases to aid in formulating effective cost-reduction strategies.

    Patient Care: It will help foster understanding of cost related issues with patient management

    Learning Objectives: To improve understanding of trends in costs related to surgery


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