Document Detail


Mortality rates, hospital length of stay, and the cost of treating subarachnoid hemorrhage in older patients: institutional and geographical differences.
MedLine Citation:
PMID:  9120619     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
The risk of disability and death and the cost of medical care are particularly high for patients with aneurysmal subarachnoid hemorrhage (SAH) who are 65 years of age or older. A retrospective analysis of 47,408 Medicare patients treated over an 8-year period was performed to determine whether a relationship exists between the mortality rate and surgical volume for older patients with SAH. The mortality rate, length of stay in the hospital, and cost of treatment for patients with SAH in California and New York state were also compared. The mortality rate was 14.3% for patients with SAH who were 65 years old or older and who were treated surgically in hospitals in which an average of five or more craniotomies were performed per year; in hospitals averaging between one and five craniotomies annually the mortality rate was 18.4%; and in those averaging less than one such operation per year the rate was 20.5% (trend p = 0.01). There was no difference in the mortality rate for patients in California versus the rate for those in New York. Surgically and medically treated patients, respectively, left the hospital an average of 6.7 and 5.1 days sooner in California than in New York. The unadjusted average reimbursement from Medicare to hospitals for surgically treated patients averaged $1468 more in New York than in California (p < 0.0001), but was equivalent for medically treated patients in the two states. The mortality rate in older patients who are treated surgically for SAH may be inversely correlated with the annual number of craniotomies performed for SAH in patients 65 years of age or older at a given institution. Hospital stays for patients with SAH are significantly shorter in California than in New York.
Authors:
C L Taylor; Z Yuan; W R Selman; R A Ratcheson; A A Rimm
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Publication Detail:
Type:  Comparative Study; Journal Article    
Journal Detail:
Title:  Journal of neurosurgery     Volume:  86     ISSN:  0022-3085     ISO Abbreviation:  J. Neurosurg.     Publication Date:  1997 Apr 
Date Detail:
Created Date:  1997-04-23     Completed Date:  1997-04-23     Revised Date:  2006-11-15    
Medline Journal Info:
Nlm Unique ID:  0253357     Medline TA:  J Neurosurg     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  583-8     Citation Subset:  AIM; IM    
Affiliation:
Department of Neurological Surgery, Case Western Reserve University School of Medicine, Cleveland, Ohio, USA.
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MeSH Terms
Descriptor/Qualifier:
Aged
Aging / physiology*
California
Craniotomy
Female
Health Care Costs*
Health Services / utilization
Hospitals
Humans
Length of Stay*
Male
Medicare
New York
Subarachnoid Hemorrhage / mortality*,  therapy*
United States

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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