Abstract Details

Title Unsustainable Hospital Costs in the Treatment of Medicare Beneficiaries Admitted with Aneurysmal Subarachnoid Hemorrhage

Topic Cerebrovascular Disease and Interventional Neurology

Presentation(s) P03 - (-)

Poster/Presentation
Number 165

Objective

Background BACKGROUND: Rising medical expenditures and the discrepancies in Medicare reimbursements have placed restraints on the health care delivery system.

Design/Methods DESIGN/METHODS: Patients entered in the Nationwide Inpatient Sample between 2009 and 2010, with International Classification of Diseases codes for a diagnosis of ruptured aneurysm who underwent either surgical or endovascular treatment of the cerebral aneurysm, were included in the study. Factors associated with higher hospitalization cost were identified and correlations with age, sex, medical co-morbidities, and discharge status were examined.

Results RESULTS: In 2009 and 2010, the average hospital charges for the 9,097 Medicare patients admitted with a ruptured aneurysm were $270,937 for patients treated with endovascular and $259,131 for patients treated with surgical treatment. These charges are substantially higher than the 2008 average Medicare (MS-DRG) payment, $36,304 for treatment of patients with co morbidity, and $30,380 without co morbidity. A greater number of endovascular treatments were performed, 6290, compared to 2807 surgical treatments. Of both treatments, women were more frequently treated. 78.4% of surgical treatments and 73.3% of endovascular treatments were for women. A higher percentage of patients treated with endovascular treatment had minimal disability at discharge compared with patients treated with surgical treatment (26.9% vs 16.8%, p=0.005). However, the re-imbursement of both treatments was equivalent.

Conclusions CONCLUSIONS: Hospitalization charges for the care of Medicare beneficiaries who undergo surgical or endovascular treatment of ruptured aneurysms are significantly higher than Medicare reimbursement. Women undergo the majority of treatments and endovascular treatment appears to be associated with less disability at discharge. The current discrepancies in hospital expenses and reimbursement may lead to unsustainable healthcare delivery for these patients.

Authors/Disclosures
PRESENTER	No disclosure on file
	No disclosure on file
	No disclosure on file
Hamza I. Maqsood, MD (Dept of Neurology)	Dr. Qureshi has received personal compensation in the range of $5,000-$9,999 for serving as a Consultant for AstraZeneca.
Rahul Sasane, PhD (Cerevel Therapeutics)	Dr. Sasane has received personal compensation for serving as an employee of Cerevel Therapeutics. Dr. Sasane has stock in Cerevel Therapeutics.

��ɫ��

��ɫ��