• Neurosurgery · Oct 2017

    Healthcare Resource Utilization and Patient-Reported Outcomes Following Elective Surgery for Intradural Extramedullary Spinal Tumors.

    • Silky Chotai, Scott L Zuckerman, Scott L Parker, Joseph B Wick, David P Stonko, Andrew T Hale, Matthew J McGirt, Joseph S Cheng, and Clinton J Devin.
    • Department of Orthopedics Surgery and Department of Neurological surgery, Spinal Column Surgical Quality and Out-comes Research Laboratory, Vanderbilt University Medical Center, Nashville, Tennessee.
    • Neurosurgery. 2017 Oct 1; 81 (4): 613-619.

    BackgroundHealthcare resource utilization and patient-reported outcomes (PROs) for intradural extramedullary (IDEM) spine tumors are not well reported.ObjectiveTo analyze the PROs, costs, and resource utilization 1 year following surgical resection of IDEM tumors.MethodsPatients undergoing elective spine surgery for IDEM tumors and enrolled in a single-center, prospective, longitudinal registry were analyzed. Baseline and postoperative 1-year PROs were recorded. One-year spine-related direct and indirect healthcare resource utilization was assessed. One-year resource use was multiplied by unit costs based on Medicare national payment amounts (direct cost). Patient and caregiver workday losses were multiplied by the self-reported gross-of-tax wage rate (indirect cost).ResultsA total of 38 IDEM tumor patients were included in this analysis. There was significant improvement in quality of life (EuroQol-5D), disability (Oswestry and Neck Disability Indices), pain (Numeric rating scale pain scores for back/neck pain and leg/arm pain), and general physical and mental health (Short-form-12 health survey, physical and mental component scores) in both groups 1 year after surgery (P < .0001). Eighty-seven percent (n = 33) of patients were satisfied with surgery. The 1-year postdischarge resource utilization including healthcare visits, medication, and diagnostic cost was $4111 ± $3596. The mean total direct cost was $23 717 ± $7412 and indirect cost was $5544 ± $4336, resulting in total 1-year cost $29 177 ± $9314.ConclusionSurgical resection of the IDEM provides improvement in patient-reported quality of life, disability, pain, general health, and satisfaction at 1 year following surgery. Furthermore, we report the granular costs of surgical resection and healthcare resource utilization in this population.Copyright © 2016 by the Congress of Neurological Surgeons

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