Cranial surgery among Medicare beneficiaries.
BACKGROUND
This article examines the incidence of inpatient cranial surgery among Medicare beneficiaries. Many of these surgeries are trauma related or reflect chronic disabilities. The costs of care and the mortality rates are high for these patients.


METHODS
A retrospective study examined the inpatient discharge data on Medicare fee-for-service beneficiaries during FY 1997 for diagnosis-related groups 1, 2, and 484. Incidence patterns, length of hospital stay, and mortality were examined by age, race, sex, source of admission, and discharge destination.


RESULTS
Approximately 86% of the Medicare cranial surgery patients were 65 years of age or older, but only 10.2% were 85 years of age or older. The average patient age was 72 years. Nearly 51% of the patients were male, and 86.3% were white. Approximately 35% of the patients were admitted from the emergency room. The average length of stay was 9.6 days, and the average intensive care unit stay was 3.5 days. Whereas 42.3% of the patients were discharged to home, 44.6% were discharged to postacute care, and 10.9% died in the hospital. The average inpatient charge was $30,746.


CONCLUSIONS
Cranial surgery in the Medicare population results in high inpatient mortality and high rates of postacute care use, especially as patient age increases.
Buczko
William
W
Office of Research, Development, and Information, DHHS/Centers for Medicare and Medicaid Services, Baltimore, Maryland 21244-1850, USA. WBuczko@cms.hhs.gov
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D016009:Chi-Square Distribution; D006259:Craniocerebral Trauma / Q000401:mortality / Q000601:surgery*; D003399:Craniotomy / Q000706:statistics & numerical data; D005260:Female; D017052:Hospital Mortality; D006801:Humans; D007902:Length of Stay / Q000706:statistics & numerical data; D008137:Longitudinal Studies; D008297:Male; D006278:Medicare; D008875:Middle Aged; D012189:Retrospective Studies; D014481:United States / Q000453:epidemiology