Healthcare Utilization and Costs for Patients With Parkinson's Disease After Deep Brain Stimulation

Autor:	Kenneth A. Follett, Kevin T. Stroupe, Lishan Cao, Frances M. Weaver, Dolores Ippolito, Bridget Smith, Zhiping Huo, Beverly Gonzalez
Rok vydání:	2019
Předmět:	0301 basic medicine medicine.medical_specialty Parkinson's disease Deep brain stimulation medicine.medical_treatment Disease 030105 genetics & heredity 03 medical and health sciences 0302 clinical medicine Health care medicine Research Articles health care economics and organizations Health professionals business.industry medicine.disease Confidence interval nervous system diseases surgical procedures operative nervous system Neurology Healthcare utilization Propensity score matching Emergency medicine Neurology (clinical) business therapeutics 030217 neurology & neurosurgery
Zdroj:	Movement Disorders Clinical Practice. 6:369-378
ISSN:	2330-1619
DOI:	10.1002/mdc3.12765
Popis:	OBJECTIVE: To compare the complications, healthcare utilization and costs following DBS or medical management for patients with Parkinson's disease (PD). METHODS: We examined healthcare utilization and costs for up to 5 years between veterans with DBS and those with medical management for PD. Veterans who received DBS between 2007 and 2013 were matched with veterans who received medical management using propensity score approaches. Healthcare utilization and costs were obtained from national VA and Medicare data sources and compared using procedures to adjust for potential differences in length of follow‐up. RESULTS: We identified 611 veterans who had received DBS and a matched group of 611 veterans who did not undergo DBS. Among DBS patients, 59% had the electrodes and generator implanted during separate admissions. After 5 years of follow‐up, average total healthcare costs, including DBS procedures and complications, were $77,131 (95% confidence interval: $66,095–$88,168; P < 0.001) higher per person for patients who received DBS ($162,489) than patients who received medical management ($85,358). In contrast, excluding the costs of the DBS procedures and complications, average total costs were not significantly different between patients who received DBS and patients who received medical management after 5 years of follow‐up. CONCLUSIONS: Healthcare costs over 5 years were higher for veterans who received DBS. These higher healthcare costs may reflect the costs of DBS procedures and any follow‐up required plus greater surveillance by healthcare professionals following DBS as well as unobserved differences in the patients who received medical management or DBS.
Databáze:	OpenAIRE
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