A comparison of craniotomy and Gamma Knife charges in a community-based Gamma Knife Center.
The hospital charges for all craniotomies and transsphenoidal procedures were gathered for a 4-year period from a single, non-profit hospital serving San Diego. Calif., USA. Of the individuals in this community 65% are covered by a variety of managed health care programs which have greatly discounted hospital receipts on a per diem or capitated payment basis. A total of 104 operative cases were identified. Forty-six patients (44%) were judged to have been eligible for Gamma Knife surgery. The average hospital charge for intracranial surgery on Gamma-Knife-eligible individuals was 14% greater than the nominal Gamma Knife surgery charge would have been. The complication rate for treated Gamma-Knife-eligible individuals was 15% including blindness in one eye after removal of a tuberculum sella meningioma, and hemiplegia following a delayed postoperative hemorrhage after arteriovenous malformation resection in another patient. Actual hospital net receipts were 55% of charges and probably approached the true hospital cost per procedure. When these hospital receipts were compared to the estimated cost per procedure of Gamma-Knife surgery, Gamma Knife surgery had a 30% cost advantage over surgical resection.
Ott
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San Diego Gamma Knife Center, Scripps Memorial Hospital, La Jolla 92103, USA.
D002140:California; D003362:Cost-Benefit Analysis; D003399:Craniotomy / Q000191:economics*; D017722:Hospital Charges; D006764:Hospitals, Community; D006801:Humans; D016634:Radiosurgery / Q000191:economics*; D012189:Retrospective Studies; D013503:Surgery Department, Hospital