Regional variation in the cost of infrainguinal lower extremity bypass surgery in the United States

Journal of Vascular Surgery
Besma NejimMahmoud B Malas

Abstract

Lower extremity bypass (LEB) remains the gold standard revascularization procedure in patients with peripheral arterial disease. The cost of LEB substantially varies based on patient's characteristics and comorbidities. The aim of this study was to assess regional variation in infrainguinal LEB cost and to identify the specific health care expenditures per service that are associated with the highest cost in each region. We identified adult patients who underwent infrainguinal LEB in the Premier database between June 2009 and March 2015. Generalized linear regression models were used to report differences between regions in total in-hospital cost and service-specific cost adjusting for patient's demographics, clinical characteristics, and hospital factors. A total of 50,131 patients were identified. The median in-hospital cost was $13,259 (interquartile range, $9308-$19,590). The cost of LEB was significantly higher in West and Northeast regions with a median cost of nearly $16,000. The high cost in the Northeast region was driven by the fixed (indirect) cost, whereas the driver of the high cost in the West region was the variable (direct) cost. The adjusted total in-hospital cost was significantly higher in all regions compare...Continue Reading

Citations

Dec 27, 2019·The Annals of Otology, Rhinology, and Laryngology·Justin YuK Kelly Gallagher
Oct 21, 2020·Journal of Neurointerventional Surgery·Matthews LanRohan V Chitale
Feb 17, 2021·Vascular and Endovascular Surgery·Nicole IlonzoRami Tadros

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