Literature DB >> 31323403

Feasibility of Bundled Payments in Anterior, Middle, and Posterior Cranial Fossa Skull Base Meningioma Surgery: MarketScan Analysis of Health Care Utilization and Outcomes.

Mayur Sharma1, Beatrice Ugiliweneza1, Maxwell Boakye1, Noberto Andaluz1, Brian J Williams2.   

Abstract

BACKGROUND: The aim of our study was to compare the health care utilization and outcomes after surgery for anterior cranial fossa skull base meningioma (AFM), middle cranial fossa skull base meningioma (MFM), and posterior cranial fossa skull base meningioma (PFM) across the United States.
METHODS: We queried the MarketScan database using International Classification of Diseases, Ninth Revision and Current Procedural Terminology 4, from 2000 to 2016. We included adult patients who had at least 24 months of enrollment after the surgical procedure. The outcome of interest was length of hospital stay, disposition, complications, and reoperation after the procedure.
RESULTS: A cohort of 1191 patients was identified from the database. Less than half of patients (43.66%) were in the AFM cohort, 32.24% were in the MFM cohort, and only 24.1% were in the PFM cohort. Patients who underwent surgery for PFM had longer hospital stay (P = 0.0009), high complication rate (P = 0.0011), and less likely to be discharged home (P = 0.0013) during index hospitalization. There were no differences in overall payments at 12 months and 24 months among the cohorts. There was no significant difference in 90-day median payments among the groups ($66,212 [AFM] vs. $65,602 [MFM] and $71,837 [PFM]; P = 0.198). Male gender, commercial insurance (compared with Medicare), and higher comorbidity scores (score 3 compared with score 0) were associated with higher 90-day payments in the PFM cohort.
CONCLUSIONS: Overall payments (at 12 months and 24 months) and 90-day payments were not different among the cohorts. Patients with PFM had longer hospital stay and higher complication rate and were less likely to be discharged home with higher utilization of outpatient services at 12 months and 24 months.
Copyright © 2019 Elsevier Inc. All rights reserved.

Entities:  

Keywords:  Anterior; Bundled payment; Health care utilization; Meningioma; Middle and posterior cranial fossa; Surgery

Year:  2019        PMID: 31323403     DOI: 10.1016/j.wneu.2019.07.078

Source DB:  PubMed          Journal:  World Neurosurg        ISSN: 1878-8750            Impact factor:   2.104


  5 in total

1.  Management of incidental anterior skull base large and giant meningiomas in elderly patients.

Authors:  Yuqian Li; Dan Lu; Dayun Feng; Hongyu Cheng; Qian Huang; Haikang Zhao; Peng Chen; Huaizhou Qin; Qing Cai
Journal:  J Neurooncol       Date:  2020-06-11       Impact factor: 4.130

2.  Health Care Utilization in Patients Undergoing Repeat Stereotactic Radiosurgery for Vestibular Schwannoma with 5-Year Follow-up: A National Database Analysis.

Authors:  Nicholas Dietz; Mayur Sharma; Beatrice Ugiliweneza; Dengzhi Wang; Maxwell Boakye; Brian Williams; Norberto Andaluz
Journal:  J Neurol Surg B Skull Base       Date:  2020-09-10

3.  90-Day Bundled Payment Simulation, Health Care Utilization, and Complications following Craniopharyngioma Resection in Adult Patients.

Authors:  Nicholas Dietz; Mayur Sharma; Kevin John; Dengzhi Wang; Beatrice Ugiliweneza; Sriprakash Mokshagundam; Martin F Bjurström; Maxwell Boakye; Brian J Williams; Norberto Andaluz
Journal:  J Neurol Surg B Skull Base       Date:  2021-12-16

4.  Incidence and Long-Term Health Care Utilization Associated With Pseudomeningocele Repair Following Vestibular Schwannoma Resection: A National Database Analysis.

Authors:  Mayur Sharma; Zaid Aljuboori; Nicholas Dietz; Dengzhi Wang; Beatrice Ugiliweneza; Brian Williams; Norberto Andaluz
Journal:  Cureus       Date:  2022-01-14

5.  Critical appraisal of minimally invasive keyhole surgery for intracranial meningioma in a large case series.

Authors:  Jai Deep Thakur; Regin Jay Mallari; Alex Corlin; Samantha Yawitz; Amalia Eisenberg; John Rhee; Walavan Sivakumar; Howard Krauss; Neil Martin; Chester Griffiths; Garni Barkhoudarian; Daniel F Kelly
Journal:  PLoS One       Date:  2022-07-28       Impact factor: 3.752

  5 in total

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