title: Burden of disease of reoperations in instrumental spinal surgeries in Germany.
abstract: OBJECTIVE
  To estimate the incidence of instrumental spinal surgeries (ISS) and consecutive reoperations and to calculate the related resource utilization and costs.
  
  
  METHODS
  ISS and subsequent reoperations were identified retrospectively using surgery codes in claims data. The study period included January 01, 2009 to December 31, 2011. The reoperation rate was calculated for 1 year after the primary ISS. Resource utilization and costs were analyzed by group comparison.
  
  
  RESULTS
  A total of 3316 incident ISS patients were identified in 2010 with an annual reoperation rate of 9.98% (95% CI 8.98-11.02%). Mean costs per patient were €11,331 per ISS and €11,370 per reoperation, with €8432 directly attributed to the reoperation and €2938 to additional resources.
  
  
  CONCLUSIONS
  Costs of ISS and subsequent reoperations have a significant impact on health insurances budgets. The annual cost of reoperations exceeds the direct cost of the primary surgery driven by the need for further inpatient and outpatient care.
authors.affiliation: Xcenda GmbH, Lange Laube 31, 30159, Hannover, Germany. Christian.Jacob@Xcenda.com.
authors.forename: Christian
authors.initials: C
authors.lastname: Jacob
authors.affiliation: Medtronic International Trading Sàrl, Route de Molliau 31, 1131, Tolochenaz, Switzerland.
authors.forename: Elena
authors.initials: E
authors.lastname: Annoni
authors.affiliation: Xcenda GmbH, Lange Laube 31, 30159, Hannover, Germany.
authors.forename: Jennifer Scarlet
authors.initials: JS
authors.lastname: Haas
authors.affiliation: Xcenda GmbH, Lange Laube 31, 30159, Hannover, Germany.
authors.forename: Sebastian
authors.initials: S
authors.lastname: Braun
authors.affiliation: Klinikum Osnabrück GmbH, Am Finkenhügel 3, 49076, Osnabrück, Germany.
authors.forename: Michael
authors.initials: M
authors.lastname: Winking
authors.affiliation: Klinikum Dortmund, Beurhausstraße 40, 44137, Dortmund, Germany.
authors.forename: Jörg
authors.initials: J
authors.lastname: Franke
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D005858:Germany; D017048:Health Care Costs / Q000706:statistics & numerical data*; D006295:Health Resources / Q000706:statistics & numerical data; D006302:Health Services Research / Q000379:methods; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D019635:Neurosurgical Procedures / Q000191:economics; D012086:Reoperation / Q000191:economics / Q000706:statistics & numerical data; D012189:Retrospective Studies; D013122:Spinal Diseases / Q000191:economics / Q000601:surgery*; D013131:Spine / Q000601:surgery*
keywords: Claims data; Costs; Instrumental spinal surgeries; Reoperation; Resource utilization