title: Comparative hospital economics and patient presentation: vertebroplasty and kyphoplasty for the treatment of vertebral compression fracture.
abstract: OBJECTIVE
  Previous studies evaluating vertebral augmentation procedure costs have not made detailed comparisons between vertebroplasty and kyphoplasty. Our study contrasts hospital costs for vertebroplasty versus kyphoplasty for the treatment of vertebral compression fractures in routine clinical practice in the United States.
  
  
  METHODS
  This retrospective cohort study analyzed 2007-2008 hospital discharge and billing records from the Premier Perspective data base. The primary outcome variable, differences in total hospital cost between vertebroplasty and kyphoplasty, was assessed by using analysis of covariance.
  
  
  RESULTS
  Three thousand six hundred seventeen patients received vertebroplasty (64% inpatient, 36% outpatient), and 8118 received kyphoplasty (54% inpatient, 46% outpatient). Approximately 75% were women, and most were white. Mean total unadjusted inpatient costs were $9837 for vertebroplasty versus $13 187 for kyphoplasty (P < .0001). Outpatient vertebroplasty costs were $3319 versus $8100 for kyphoplasty (P < .0001). Lower vertebroplasty costs were largely due to differences in hospital supply and OR. Mean vertebroplasty OR costs were $73.60 (anesthesia), $112.06 (recovery room), and $990.12 (surgery) versus $172.16 (anesthesia), $257.47 (recovery room), and $1,471.49 (surgery) with kyphoplasty. Adjustments for age, sex, admission status, and disease severity accentuated the differences. Mean adjusted inpatient costs were $11 386 for vertebroplasty versus $16 182 for kyphoplasty (P < .0001), and outpatient costs were $2997 for vertebroplasty versus $7010 for kyphoplasty (P < .0001). After adjustments for the same covariates, length-of-stay differences were no longer evident (P = .4945).
  
  
  CONCLUSIONS
  Performing vertebroplasty versus kyphoplasty reduces hospital costs by nearly $5000 for inpatient procedures and by more than $4000 for outpatient procedures.
authors.affiliation: Department of Anesthesiology, Boston University Medical Center, Boston, Massachusetts, USA.
authors.forename: A K
authors.initials: AK
authors.lastname: Mehio
authors.forename: J H
authors.initials: JH
authors.lastname: Lerner
authors.forename: L M
authors.initials: LM
authors.lastname: Engelhart
authors.forename: C M
authors.initials: CM
authors.lastname: Kozma
authors.forename: T L
authors.initials: TL
authors.lastname: Slaton
authors.forename: N C
authors.initials: NC
authors.lastname: Edwards
authors.forename: G J
authors.initials: GJ
authors.lastname: Lawler
mesh_terms: D000208:Acute Disease; D000368:Aged; D000556:Ambulatory Surgical Procedures / Q000191:economics / Q000706:statistics & numerical data; D015331:Cohort Studies; D017046:Cost Savings / Q000191:economics / Q000706:statistics & numerical data; D016208:Databases, Factual / Q000706:statistics & numerical data; D005260:Female; D050815:Fractures, Compression / Q000191:economics* / Q000453:epidemiology / Q000601:surgery; D006742:Hospital Bed Capacity / Q000191:economics / Q000706:statistics & numerical data; D017721:Hospital Costs / Q000706:statistics & numerical data*; D006801:Humans; D007297:Inpatients / Q000706:statistics & numerical data; D058498:Kyphoplasty / Q000191:economics* / Q000706:statistics & numerical data; D007902:Length of Stay / Q000191:economics / Q000706:statistics & numerical data; D008297:Male; D010045:Outpatients / Q000706:statistics & numerical data; D012189:Retrospective Studies; D016103:Spinal Fractures / Q000191:economics* / Q000453:epidemiology / Q000601:surgery; D014481:United States / Q000453:epidemiology; D054854:Vertebroplasty / Q000191:economics* / Q000706:statistics & numerical data