Department of Neurologic Surgery, Mayo Clinic, Rochester, Minnesota, USA.
Department of Anesthesiology, Mayo Clinic, Rochester, Minnesota, USA.
World Neurosurg. 2021 Mar;147:e171-e188. doi: 10.1016/j.wneu.2020.12.012. Epub 2020 Dec 25.
In this study, we sought to characterize contemporary trends in cost and utilization of spinal cord stimulation (SCS).
The Healthcare Cost and Utilization Project-National Inpatient Sample was queried for inpatient admissions from 2008 to 2014 where SCS was performed. We then determined the rates and costs of SCS performed in this time frame to treat diagnoses that we classified as device-related complications, degenerative spine disease, pain syndromes, and neuropathies/neuritis/nerve lesions. Least-squares regression was performed to determine the yearly trends for each indication adjusted by the total number of yearly hospitalizations for that diagnosis.
We identified a total of 6876 admissions in whom an SCS was performed. The overall rate of inpatient SCS procedures performed has decreased by 45% from 2008 to 2014 (14.0 to 7.7 procedures per 100,000 admissions). Adjusted analysis for yearly trends also demonstrated a declining trend for all indications; however, this was not found to be statistically significant, except for device-related complications (P = 0.004). The median inflation-adjusted cost of an admission where SCS was performed increased slightly by 7.4% from $26,200 (IQR: $16,700-$33,800) in 2008 to $28,100 (IQR: $19,600-$36,900) in 2014. Billed hospital charges demonstrated a significant increase with median inflation-adjusted admission charge of $66,068 in 2008 to $110,672 in 2014.
Despite a declining contemporary trend in inpatient SCS, an increase was noted in admission costs and hospital charges. A significant declining trend was noted in revision SCS implantations due to device-related complications.
本研究旨在描述脊髓刺激（SCS）的成本和利用的当代趋势。
查询 2008 年至 2014 年期间在国家住院患者样本中进行 SCS 的住院患者。然后，我们确定在此期间内治疗我们归类为设备相关并发症、退行性脊柱疾病、疼痛综合征和神经病变/神经炎/神经损伤的诊断的 SCS 实施率和成本。进行最小二乘法回归，以确定每个适应证的每年趋势，根据该诊断的每年住院总数进行调整。
我们共确定了 6876 例接受 SCS 治疗的患者。从 2008 年到 2014 年，住院 SCS 手术的总体发生率下降了 45%（每 100,000 例住院患者 14.0 至 7.7 例）。对每年趋势进行的调整分析也表明所有适应证均呈下降趋势；然而，除设备相关并发症外（P=0.004），这并未显示出统计学意义。进行 SCS 治疗的住院患者的中位数通胀调整后成本从 2008 年的 26200 美元（IQR：16700-33800 美元）略有增加 7.4%至 2014 年的 28100 美元（IQR：19600-36900 美元）。计费医院收费显示出显著增加，2008 年的中位数通胀调整后入院收费为 66068 美元，2014 年为 110672 美元。
尽管住院 SCS 的当代趋势呈下降趋势，但入院费用和医院收费有所增加。由于设备相关并发症，SCS 修复植入术的显著下降趋势。
