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Trends in Cost of Unilateral Breast Implant Removal in Urban Teaching Hospitals
Arvin Smith BA, Yida Cai BS, Corinne Wee MD, Mohammed Awad MD, Donald Harvey MD
University Hospitals Medical Center, Cleveland
2020-02-15
Presenter: Arvin Smith
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.
Director Name: Anand Kumar
Author Category: Medical Student
Presentation Category: Clinical
Abstract Category: Breast (Aesthetic and Recon.)
Background: The economics and demographics of breast implant explantation are poorly understood. Explantation may result from infection, capsular contracture, hematoma, or elective removal. The national economic and demographic metrics of unilareral implant removal in the inpatient setting were analyzed.
Methods: Secondary cross-sectional analysis of the National Inpatient Sample (NIS) database from Q1 2008 to Q3 2015 was performed. Hospital inpatient data for unilateral implant removal without re-implantation at all urban teaching centers were collected. Patients were organized by ICD-9-CM diagnosis codes. R version 3.6.2 was utilized for statistical analysis. A least squared regression test was conducted on cost, region, and payer type.
Results: 438 patients underwent unilateral breast implant removal. 69% had a history of breast cancer, 2% presented with capsular contracture, 73.4% presented with infection, and 0.5% presented with a hematoma. Regression of cost per length of stay was conducted for each region (1=northeast, 2=midwest, 3=south, 4=west coast) and payment type (Medicare, Medicaid, self-pay, private insurance) from 2008-2015. Cost increased significantly on the west coast (coefficient 587.6, p<0.05). Medicare payment also increased significantly (coefficient 853.6, p < 0.05).
Conclusion: Patients who underwent unilateral breast implant removal at urban teaching hospitals requiring inpatient admission typically presented with implant infection or a history of breast cancer. Fewer patients with capsular contracture, hematoma, or elective removal required inpatient admission. The cost for implant removal was higher in the west coast region and medicare costs have increased from 2008-2015.
