Spinal Cord Stimulation Infection Rate and Incremental Annual Expenditures: Results From a United States Payer Database
Spinal Cord Stimulation Infection Rate and Incremental Annual Expenditures: Results From a United States Payer Database
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DOI：
10.1111/ner.12939
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发表时间：
2019-04-01
期刊：
影响因子：
2.8
通讯作者：
Doth, Alissa H.
中科院分区：
文献类型：
--
作者：
Provenzano, David A.;Falowski, Steven M.;Doth, Alissa H.
目的手术部位感染（SSI）导致显著的临床和经济后果。本研究的目的是估计每年的健康支出与脊髓刺激（SCS）相关的infection.Materials和MethodsData从Truven MarketScan（R）数据库被用来识别患者与SCS植入（2009-2014）和连续的健康计划登记至少12个月之前和之后的植入（索引日期）。估计了自索引日期以来发生器械相关感染的患者与未发生感染的患者的年度支出。广义线性模型估计了器械相关感染的年度支出。多变量支出模型分别进行初始和更换组的患者，控制人口统计学，合并症，和临床characteristics.ResultsThe研究包括6615例患者。多变量支出模型显示，感染患者的年支出高于未感染患者。初始植入患者感染患者的估计增量年度医疗支出为59，716美元（95% CI：48，965 - 69，480美元），置换患者为64，833美元（95% CI：37，377 - 86，519美元）。只有26%的患者谁被感染的patiented进行了reimplant.ConclusionsThese结果显示与SCS相关感染的重大支出负担。从临床和经济角度来看，SCS相关感染的管理都很重要。本文提供的经济和临床数据加强了医疗保健提供者进行额外研究和策略的必要性，以尽量减少SCS感染。今后需要进行经济研究，以进一步确定与广泛支出负担相关的具体经济成本驱动因素。
ObjectivesSurgical site infections (SSIs) result in significant negative clinical and economic outcomes. The objective of this study is to estimate annual health expenditures associated with spinal cord stimulation (SCS)-related infections.Materials and MethodsData from the Truven MarketScan (R) databases were used to identify patients with an SCS implant (2009-2014) and a continuous health plan enrollment for at least 12-months before and after implant (index date). Annual expenditures were estimated for patients with a device-related infection vs. those without infection since index date. A generalized linear model estimated annual expenditures attributable to device-related infection. Multivariable expenditure models were conducted separately for patients in initial and replacement groups, controlling for demographics, comorbidities, and clinical characteristics.ResultsThe study included 6615 patients. Multivariable expenditure models revealed that patients with infection have higher annual expenditures than patients without infection. Estimated incremental annual healthcare expenditures for patients with an infection were $59,716 (95% CI: $48,965-$69,480) for initial implanted patients and $64,833 (95% CI: $37,377-$86,519) for replacement patients. Only 26% of patients who were explanted for infection underwent a reimplant.ConclusionsThese results show the substantial expenditure burden associated with an SCS-related infection. Management of SCS-related infection is important from both clinical and economic standpoints. The economic and clinical data presented here reinforce the need for additional research and strategies for healthcare providers to minimize SCS infections. Future economic research is needed to further define the specific economic cost drivers associated with the extensive expenditure burden.