Abstract
Patient out-of-pocket (OOP) spending is an increasingly discussed topic; however, there is minimal data available on the patient financial burden of surgical procedures. To analyze hospital and surgeon expected payment data and patient OOP spending in neurosurgery. This is a retrospective cohort study of neurosurgical patients at a tertiary-referral center from 2013 to 2016. Expected payments, reflecting negotiated costs-of-care, as well as actual patient OOP payments for hospital care and surgeon professional fees were analyzed. A 4-tiered model of patient OOP cost sharing and a multivariate model of patient expected payments were created. A total of 13 673 consecutive neurosurgical cases were analyzed. Patient age, insurance type, case category, severity of illness, length of stay (LOS), and elective case status were significant predictors of increased expected payments (P < .05). Craniotomy ($53 397 ± 811) and posterior spinal fusion ($48 329 ± 864) were associated with the highest expected payments. In a model of patient OOP cost sharing, nearly all neurosurgical procedures exceeded yearly OOP maximums for Healthcare Marketplace plans. Mean patient payments for hospital care and surgeon professional fees were the highest fo...Continue Reading
References
Aug 21, 2003·JAMA : the Journal of the American Medical Association·G Caleb AlexanderDavid O Meltzer
Jul 10, 2004·Journal of General Internal Medicine·G Caleb AlexanderDavid O Meltzer
Apr 11, 2007·Archives of Internal Medicine·Hoangmai H PhamAnn S O'Malley
Jan 25, 2008·The New England Journal of Medicine·Amal N TrivediJohn Z Ayanian
Apr 12, 2008·Medical Care Research and Review : MCRR·Judith H HibbardMartin Tusler
Jan 7, 2009·Health Affairs·Kathryn Anne PaezWenke Hwang
Jan 29, 2010·The New England Journal of Medicine·Amal N TrivediVincent Mor
Dec 3, 2011·Journal of Neurosurgery. Pediatrics·Chevis N ShannonJohn C Wellons
Feb 28, 2013·The Oncologist·S Yousuf ZafarAmy P Abernethy
Jul 23, 2013·Journal of Health Economics·George LoewensteinKevin G Volpp
Oct 18, 2013·The New England Journal of Medicine·Peter A UbelS Yousuf Zafar
Oct 18, 2014·Journal of Neurosurgery. Spine·Yakov GologorskyMichael W Groff
Oct 22, 2014·JAMA : the Journal of the American Medical Association·Christopher WhaleyNeeraj Sood
Nov 2, 2014·Journal of Neuro-oncology·Tobias WalbertTerri S Armstrong
Jan 7, 2015·Health Affairs·Mary K CatlinCathy A Cowan
Sep 24, 2015·Health Affairs·Gary ClaxtonMichelle Long
Jul 2, 2016·JAMA Internal Medicine·Emily R AdrionBrahmajee K Nallamothu
Sep 21, 2016·Parkinsonism & Related Disorders·John D RolstonPaul S Larson
Dec 8, 2016·JAMA Surgery·Corinna C ZygourakisRalph Gonzales
Mar 23, 2017·Neurosurgery·Corinna C ZygourakisRalph Gonzales
Apr 13, 2017·Neurosurgery·Corinna C ZygourakisRalph Gonzales
Sep 21, 2017·Health Affairs·Gary ClaxtonGregory Foster
Citations
Jul 30, 2021·PloS One·Regin Jay MallariDaniel F Kelly
Aug 10, 2021·Journal of Huntington's Disease·Marie DavisThomas Bird
Oct 3, 2020·Journal of Neurosurgery·Oliver Y TangSteven A Toms