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National Trends in Hospitalization Charges for Implant Based Breast Reconstruction
Yida Cai BA, Lesley Summerville BS, ScM, Samuel Boas BS, Anand Kumar MD
Case Western Reserve University School of Medicine
2020-01-31
Presenter: Yida Cai BA
Affidavit:
I certify that the material proposed for presentation in this abstract has not been published in any scientific journal or previously presented at a major meeting. The program director is responsible for making a statement within the confines of the box below specific to how much of the work on this project represents the original work of the resident. All authors/submitters of each abstract should discuss this with their respective program director for accurate submission of information as well as the program director's approval for inclusion of his/her electronic signature.
Director Name: Anand Kumar MD
Author Category: Medical Student
Presentation Category: Clinical
Abstract Category: Breast (Aesthetic and Recon.)
PURPOSE: There exists significant cost variation among patients undergoing implant based breast reconstruction. Our study analyzes the factors influencing hospital charges relating to implant based breast reconstruction.
METHODS: The Healthcare Cost and Utilization Project (HCUP) National Inpatient Sample (NIS) database was analyzed via secondary cross-sectional analysis from January 2009 to December 2014. All female patients who underwent mastectomy followed by immediate implant based breast reconstruction were included. Univariate and generalized linear models were used to examine associations between various factors of interest and the final adjusted charge associated with each hospitalization.
RESULTS: 659,220 female patients were diagnosed with breast cancer or had a high risk of breast cancer during our study period. 44,175 (6.7%) received implant-based breast reconstruction. The mean total hospital charge was $55,188.89 (interquartile range: $37,860.40 – $81,351.37). The the proportion of patients who received the procedure did not significantly change (p = 0.113). However, the average total charges for the hospitalization increased significantly (p < 0.001), despite an overall decrease in length of stay (p < 0.001). Procedures in West were associated with significantly higher charges when compared to other regions ($84,908.78). Higher charges were also associated with urban hospitals.
CONCLUSION: Increasing hospitalization charges were observed in the setting of decreasing length of stay, originally thought to be the main contributor to regional cost variation. Further studies will be done to develop strategies to better target increased hospitalization charges, as the overall healthcare burden of this procedure is expected to rise if current trends continue.
