Stereotaxy reduces cost of brain tumor resection.
BACKGROUND
Health care professionals are under increasing pressure to contain the cost of health care. Simultaneously, medical technology continues to advance. Medical institutions must therefore consider the costs and benefits before using a new technology. Using a direct costing system, we determined the cost efficacy of stereotaxy applied to the resection of brain mass lesions.


METHODS
Twenty-nine patients underwent a stereotactically guided craniotomy and brain tumor resection. Fifteen of them underwent general and fourteen received local anesthesia. Twelve other patients, comprising a historical reference group, underwent a standard craniotomy and brain tumor resection under general anesthesia. costs were determined for every hospital charge item in all patients. Cost efficiency was then compared between the two groups.


RESULTS
Patients treated stereotactically incurred additional costs in frame placement and neuroimaging. These costs were offset by savings in operating room time, patient acuity, length of stay, respiratory care, and medications. Savings were greatest for patients who had local anesthesia. Overall, patients treated by stereotactic craniotomy had a total hospitalization cost of $8,495.19, whereas those treated with standard craniotomy incurred a cost of $11,365.23 (p < 0.001).


CONCLUSIONS
Stereotaxy is cost effective for the surgical treatment of brain tumors. Accurate estimates of cost can justify the use of medical technology. Directly measured cost data is a useful index for any cost containment program.
Polinsky
M N
MN
Section of Neurosurgery, University of Michigan, Ann Arbor, USA.
Geer
C P
CP
Ross
D A
DA
D000293:Adolescent; D000328:Adult; D000368:Aged; D000768:Anesthesia, General / Q000191:economics; D000772:Anesthesia, Local / Q000191:economics; D001932:Brain Neoplasms / Q000191:economics* / Q000601:surgery*; D005260:Female; D017722:Hospital Charges / Q000706:statistics & numerical data*; D006801:Humans; D007902:Length of Stay; D008297:Male; D008824:Michigan; D008875:Middle Aged; D016522:Oncology Service, Hospital / Q000191:economics; D012720:Severity of Illness Index; D013238:Stereotaxic Techniques / Q000191:economics*; D013503:Surgery Department, Hospital / Q000191:economics