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Geographic variation in cost of care for pituitary tumor surgery

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Abstract

Purpose

Geography is known to affect cost of care in surgical procedures. Understanding the relationship between geography and hospital costs is pertinent in the effort to reduce healthcare costs. We studied the geographic variation in cost for transsphenoidal pituitary surgery in hospitals across New York State.

Methods

Using the Healthcare Cost and Utilization Project State Inpatient Database for New York from 2008 to 2011, we analyzed records of patients who underwent elective transsphenoidal pituitary tumor surgery and were discharged to home or self-care. N.Y. State was divided into five geographic regions: Buffalo, Rochester, Syracuse, Albany, and Downstate. These five regions were compared according to median charge and cost per day.

Results

From 2008 to 2011, 1803 transsphenoidal pituitary tumor surgeries were performed in New York State. Mean patient age was 50.7 years (54 % were female). Adjusting prices for length of stay, there was substantial variation in prices. Median charges per day ranged from $8485 to $13,321 and median costs per day ranged from $2962 to $6837 between the highest and lowest regions from 2008 to 2011.

Conclusion

Within New York State, significant geographic variation exists in the cost for transsphenoidal pituitary surgery. The significance of and contributors to such variation is an important question for patients, providers, and policy makers. Transparency of hospital charges, costs, and average length of stay for procedures to the public provides useful information for informed decision-making, especially for a highly portable disease entity like pituitary tumors.

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Funding

The research reported in this manuscript received intramural funding by the UR Medicine Pituitary Program, University of Rochester Medical Center.

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Authors and Affiliations

  1. Department of Neurosurgery, School of Medicine and Dentistry, University of Rochester Medical Center, 601 Elmwood Ave, Box 670, Rochester, NY, 14642, USA

    Charles C. Lee, Kristopher T. Kimmell & G. Edward Vates

  2. Department of Biostatistics and Computational Biology, University of Rochester Medical Center, 601 Elmwood Ave, Box 630, Rochester, NY, 14642, USA

    Amy Lalonde & Peter Salzman

  3. Department of Otolaryngology, University of Rochester Medical Center, 601 Elmwood Ave, Box 629, Rochester, NY, 14642, USA

    Matthew C. Miller & G. Edward Vates

  4. Division of Endocrine, Diabetes, and Metabolism, University of Rochester Medical Center, 601 Elmwood Ave, Box 693, Rochester, NY, 14642, USA

    Laura M. Calvi, Ekaterina Manuylova, Ismat Shafiq & G. Edward Vates

  5. UR Medicine Pituitary Program, University of Rochester Medical Center, 601 Elmwood Ave, Box 670, Rochester, NY, 14642, USA

    Charles C. Lee, Laura M. Calvi, Ekaterina Manuylova, Ismat Shafiq & G. Edward Vates

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  1. Charles C. Lee
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Correspondence to Charles C. Lee.

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Lee, C.C., Kimmell, K.T., Lalonde, A. et al. Geographic variation in cost of care for pituitary tumor surgery. Pituitary 19, 515–521 (2016). https://doi.org/10.1007/s11102-016-0738-x

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  • DOI: https://doi.org/10.1007/s11102-016-0738-x

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