Value-based neurosurgery: Measuring and reducing the cost of microvascular decompression surgery

Journal of Neurosurgery

Volumn 121, Issue 3, 2014, Pages 700-708

  McLaughlin, Nancy ^a   Upadhyaya, Pooja ^a   Buxey, Farzad ^a   Martin, Neil A ^a  

^a UNIVERSITY OF CALIFORNIA   (United States)

Author keywords

Cost; Intraoperative monitoring; Microvascular decompression; Outcome; Readmission; Surgical complication; Value

Indexed keywords

ADULT; ARTICLE; CLINICAL ARTICLE; COST CONTROL; FEMALE; HEALTH CARE COST; HOSPITAL READMISSION; HOSPITALIZATION; HUMAN; INCISION; LENGTH OF STAY; MALE; MICROVASCULAR DECOMPRESSION; NEUROMONITORING; NEUROSURGERY; OPERATION DURATION; OUTCOME ASSESSMENT; PATIENT MONITORING; PRIORITY JOURNAL; REOPERATION; RETROSPECTIVE STUDY;

ABC = ACTIVITY-BASED COSTING; BAEP = BRAINSTEM AUDITORY EVOKED POTENTIAL; CON = CERTIFICATE OF NEED; COST; HFS = HEMIFACIAL SPASM; ICU = INTENSIVE CARE UNIT; INTRAOPERATIVE MONITORING; IOM = INTRAOPERATIVE NEUROMONITORING; LOS = LENGTH OF STAY; MICROVASCULAR DECOMPRESSION; MVD = MICROVASCULAR DECOMPRESSION; NIS = NATIONWIDE INPATIENT SAMPLE; OR = OPERATING ROOM; OUTCOME; READMISSION; RRMC = RONALD REAGAN UCLA MEDICAL CENTER; SURGICAL COMPLICATION; TDABC = TIME-DRIVEN ABC; TN = TRIGEMINAL NEURALGIA; VALUE;

HUMANS; MICROVASCULAR DECOMPRESSION SURGERY; NEUROSURGERY; NEUROSURGICAL PROCEDURES; RETROSPECTIVE STUDIES;

EID: 84905485399     PISSN: 00223085     EISSN: 19330693     Source Type: Journal    
DOI: 10.3171/2014.5.JNS131996     Document Type: Article

References (54)

1. Adogwa O, Parker SL, Shau DN, Mendenhall SK, Aaronson O, Cheng JS, et al: Cost per quality-adjusted life year gained of revision neural decompression and instrumented fusion for same-level recurrent lumbar stenosis: defining the value of surgical intervention. Clinical article. J Neurosurg Spine 16:135-140, 2012
2. Afsar-Manesh N, Martin NA: Healthcare reform from the inside: a neurosurgical clinical quality program. Surg Neurol Int 3:128, 2012
3. Agrawal S, Taitsman J, Cassel C: Educating physicians about responsible management of finite resources. JAMA 309:1115-1116, 2013
4. Babineau TJ, Becker J, Gibbons G, Sentovich S, Hess D, Robertson S, et al: The "cost" of operative training for surgical residents. Arch Surg 139:366-370, 2004
5. Beauregard CL, Friedman WA: Routine use of postoperative ICU care for elective craniotomy: a cost-benefit analysis. Surg Neurol 60:483-489, 2003
6. Berry SA, Doll MC, McKinley KE, Casale AS, Bothe A Jr: ProvenCare: quality improvement model for designing highly reliable care in cardiac surgery. Qual Saf Health Care 18: 360-368, 2009
7. Bond AE, Zada G, Gonzalez AA, Hansen C, Giannotta SL: Operative strategies for minimizing hearing loss and other major complications associated with microvascular decompression for trigeminal neuralgia. World Neurosurg 74:172-177, 2010
8. Brock S, Scaioli V, Ferroli P, Broggi G: Neurovascular decompression in trigeminal neuralgia: role of intraoperative neurophysiological monitoring in the learning period. Stereotact Funct Neurosurg 82:199-206, 2004
9. Bui JQ, Mendis RL, van Gelder JM, Sheridan MM, Wright KM, Jaeger M: Is postoperative intensive care unit admission a prerequisite for elective craniotomy? Clinical article. J Neurosurg 115:1236-1241, 2011
10. Casale AS, Paulus RA, Selna MJ, Doll MC, Bothe AE Jr, McKinley KE, et al: "ProvenCareSM": a provider-driven pay-for- performance program for acute episodic cardiac surgical care. Ann Surg 246:613-623, 2007
11. Chalouhi N, Jabbour P, Tjoumakaris S, Starke RM, Dumont AS, Liu H, et al: Treatment of large and giant intracranial aneurysms: cost comparison of flow diversion and traditional embolization strategies. World Neurosurg [epub ahead of print], 2013
12. Dimick JB, Chen SL, Taheri PA, Henderson WG, Khuri SF, Campbell DA Jr: Hospital costs associated with surgical complications: a report from the private-sector National Surgical Quality Improvement Program. J Am Coll Surg 199:531-537, 2004
13. Dimick JB, Pronovost PJ, Cowan JA, Lipsett PA: Complications and costs after high-risk surgery: where should we focus quality improvement initiatives? J Am Coll Surg 196:671-678, 2003
14. Fric-Shamji EC, Shamji MF: Impact of US state government regulation on patient access to elective surgical care. Clin Invest Med 31:E236-E241, 2008
15. Groman RF, Rubin KY: Neurosurgical practice and health care reform: moving toward quality-based health care delivery. Neurosurg Focus 34(1):E1, 2013
16. Gustafsson UO, Scott MJ, Schwenk W, Demartines N, Roulin D, Francis N, et al: Guidelines for perioperative care in elective colonic surgery: Enhanced Recovery After Surgery (ERAS®) Society recommendations. World J Surg 37:259-284, 2013
17. Haanschoten MC, van Straten AH, ter Woorst JF, Stepaniak PS, van der Meer AD, van Zundert AA, et al: Fast-track practice in cardiac surgery: results and predictors of outcome. Interact Cardiovasc Thorac Surg 15:989-994, 2012
18. Han PP, Shetter AG, Smith KA, Fiedler JA, Rogers CL, Speiser B, et al: Gamma knife radiosurgery for trigeminal neuralgia: experience at the Barrow Neurological Institute. Stereotact Funct Neurosurg 73:131-133, 1999
19. Holcomb BW, Wheeler AP, Ely EW: New ways to reduce unnecessary variation and improve outcomes in the intensive care unit. Curr Opin Crit Care 7:304-311, 2001
20. Hosler MR, Scott IU, Kunselman AR, Wolford KR, Oltra EZ, Murray WB: Impact of resident participation in cataract surgery on operative time and cost. Ophthalmology 119:95-98, 2012
21. Kalkanis SN, Eskandar EN, Carter BS, Barker FG II: Microvascular decompression surgery in the United States, 1996 to 2000: mortality rates, morbidity rates, and the effects of hospital and surgeon volumes. Neurosurgery 52:1251-1262, 2003
22. Kaplan RS, Anderson SR: Time-driven activity-based costing. Harv Bus Rev 82:131-138, 150, 2004
23. Kaplan RS, Porter ME: How to solve the cost crisis in health care. Harv Bus Rev 89:46-52, 54, 56-61 passim, 2011
24. Keay L, Lindsley K, Tielsch J, Katz J, Schein O: Routine preoperative medical testing for cataract surgery. Cochrane Database Syst Rev 3:CD007293, 2012
25. Keehan SP, Cuckler GA, Sisko AM, Madison AJ, Smith SD, Lizonitz JM, et al: National health expenditure projections: modest annual growth until coverage expands and economic growth accelerates. Health Aff (Millwood) 31:1600-1612, 2012
26. Kelly DF: Neurosurgical postoperative care. Neurosurg Clin N Am 5:789-810, 1994
27. Lassen K, Coolsen MM, Slim K, Carli F, de Aguilar-Nascimento JE, Schäfer M, et al: Guidelines for perioperative care for pancreaticoduodenectomy: Enhanced Recovery After Surgery (ERAS®) Society recommendations. World J Surg 37:240-258, 2013
28. Macario A: What does one minute of operating room time cost? J Clin Anesth 22:233-236, 2010
29. Martin AB, Lassman D, Washington B, Catlin A: Growth in US health spending remained slow in 2010; health share of gross domestic product was unchanged from 2009. Health Aff (Millwood) 31:208-219, 2012
30. Martino J, Gomez E, Bilbao JL, Dueñas JC, Vázquez-Barquero A: Cost-utility of maximal safe resection of WHO grade II gliomas within eloquent areas. Acta Neurochir (Wien) 155:41-50, 2013
31. McClelland S III: A cost analysis of intraoperative microelectrode recording during subthalamic stimulation for Parkinson's disease. Mov Disord 26:1422-1427, 2011
32. McLaughlin N, Afsar-Manesh N, Ragland V, Buxey F, Martin NA: Tracking and sustaining improvement initiatives: leveraging quality dashboards to lead change in a neurosurgical department. Neurosurgery 74:235-244, 2013
33. McLaughlin N, Winograd D, Chung HR, Van de Wiele B, Martin NA: University of California, Los Angeles, surgical time-out process: evolution, challenges, and future perspective. Neurosurg Focus 33(5):E5, 2012
34. Nahed BV, Babu MA, Smith TR, Heary RF: Malpractice liability and defensive medicine: a national survey of neurosurgeons. PLoS ONE 7:e39237, 2012
35. Nygren J, Thacker J, Carli F, Fearon KC, Norderval S, Lobo DN, et al: Guidelines for perioperative care in elective rectal/pelvic surgery: Enhanced Recovery After Surgery (ERAS®) Society recommendations. World J Surg 37:285-305, 2013
36. Panella M, Marchisio S, Di Stanislao F: Reducing clinical variations with clinical pathways: do pathways work? Int J Qual Health Care 15:509-521, 2003
37. Paulus RA, Davis K, Steele GD: Continuous innovation in health care: implications of the Geisinger experience. Health Aff (Millwood) 27:1235-1245, 2008
38. Pollei TR, Barrs DM, Hinni ML, Bansberg SF, Walter LC: Operative time and cost of resident surgical experience: effect of instituting an otolaryngology residency program. Otolaryngol Head Neck Surg 148:912-918, 2013
39. Pollock BE, Ecker RD: A prospective cost-effectiveness study of trigeminal neuralgia surgery. Clin J Pain 21:317-322, 2005
40. Porter ME: A strategy for health care reform-toward a valuebased system. N Engl J Med 361:109-112, 2009
41. Porter ME: What is value in health care? N Engl J Med 363:2477-2481, 2010
42. Prell J, Rampp S, Rachinger J, Scheller C, Naraghi R, Strauss C: Spontaneous electromyographic activity during microvascular decompression in trigeminal neuralgia. J Clin Neurophysiol 25:225-232, 2008
43. Ridderstolpe L, Johansson A, Skau T, Rutberg H, Ahlfeldt H: Clinical process analysis and activity-based costing at a heart center. J Med Syst 26:309-322, 2002
44. Rogers CL, Shetter AG, Fiedler JA, Smith KA, Han PP, Speiser BL: Gamma knife radiosurgery for trigeminal neuralgia: the initial experience of The Barrow Neurological Institute. Int J Radiat Oncol Biol Phys 47:1013-1019, 2000
45. Rudmik L, Drummond M: Health economic evaluation: important principles and methodology. Laryngoscope 123:1341-1347, 2013
46. Sammour T, Zargar-Shoshtari K, Bhat A, Kahokehr A, Hill AG: A programme of Enhanced Recovery After Surgery (ERAS) is a cost-effective intervention in elective colonic surgery. N Z Med J 123:61-70, 2010
47. Sindou M: Operative strategies for minimizing hearing loss associated with microvascular decompression for trigeminal neuralgia. World Neurosurg 74:111-112, 2010
48. Studdert DM, Mello MM, Sage WM, DesRoches CM, Peugh J, Zapert K, et al: Defensive medicine among high-risk specialist physicians in a volatile malpractice environment. JAMA 293:2609-2617, 2005
49. Taheri PA, Butz D, Griffes LC, Morlock DR, Greenfield LJ: Physician impact on the total cost of care. Ann Surg 231:432-435, 2000
50. Taheri PA, Butz DA, Greenfield LJ: Length of stay has minimal impact on the cost of hospital admission. J Am Coll Surg 191:123-130, 2000
51. Taylor WA, Thomas NW, Wellings JA, Bell BA: Timing of postoperative intracranial hematoma development and implications for the best use of neurosurgical intensive care. J Neurosurg 82:48-50, 1995
52. Whitmore RG, Stephen J, Stein SC, Campbell PG, Yadla S, Harrop JS, et al: Patient comorbidities and complications after spinal surgery: a societal-based cost analysis. Spine (Phila Pa 1976) 37:1065-1071, 2012
53. Wong JM, Bader AM, Laws ER, Popp AJ, Gawande AA: Patterns in neurosurgical adverse events and proposed strategies for reduction. Neurosurg Focus 33(5):E1, 2012
54. Ziai WC, Varelas PN, Zeger SL, Mirski MA, Ulatowski JA: Neurologic intensive care resource use after brain tumor surgery: an analysis of indications and alternative strategies. Crit Care Med 31:2782-2787, 2003