We wanted to study the trends in recent years, predictors of utilization and effect of hospital characteristics on outcomes following DBS using large population-based database.

We performed a cross-sectional analysis using the NIS, 2006–2014, of US adult hospitalizations with 3 primary movement disorders: Parkinson’s disease, essential tremor, and dystonia with primary diagnosis. Annual rate of DBS use was calculated using NIS weighting. Potential factors associated with increased likelihood of DBS utilization were assessed using logistic regression.

Overall, 32,163 patients underwent DBS for 3 primary movement disorders across US from 2006 till 2014. Mean age of the cohort was 64.3 ± 10.9 years and 18.7% of patients were female. Across 2006–2014, 22.1% patients received DBS; increasing from 14.2% (2006) to 32.9% (2014): p <.0001 . DBS utilization in Parkinson’s disease and essential tremor increased from 13.3% (2006) to 31.1% (2014): p <.0001 and 23.7% (2006) to 51.1% (2014): p <.0001 respectively but did not change for dystonia 8.5% (2006) to 11.9% (2014): p = 0.71. Signi?cant factors associated with higher DBS utilization were: large hospitals, teaching hospitals urban location, South or West regions, median household income above 50th percentile, private insurance  and ones associated with lower likehood were female gender, black race and Age ≥ 65 yrs.  No statistically significant difference between different hospital sizes of having unfavorable discharge, PLOS and high end hospital charges performing DBS procedure.

We found increases in overall national trends of DBS utilization in primary movement disorders but no  differences in terms of unfavorable discharge, PLOS and high end hospital charges performing DBS procedure for different hospital sizes suggesting probable improvement in techniques and patient selection. However, females, black race, non-private insurance, and lower socio-economic status had lower odds of receiving DBS.