title: Geographic variation in cost of care for pituitary tumor surgery.
abstract: OBJECTIVE
  Geography is known to affect cost of care in surgical procedures. Understanding the relationship between geography and hospital costs is pertinent in the effort to reduce healthcare costs. We studied the geographic variation in cost for transsphenoidal pituitary surgery in hospitals across New York State.
  
  
  METHODS
  Using the Healthcare Cost and Utilization Project State Inpatient Database for New York from 2008 to 2011, we analyzed records of patients who underwent elective transsphenoidal pituitary tumor surgery and were discharged to home or self-care. N.Y. State was divided into five geographic regions: Buffalo, Rochester, Syracuse, Albany, and Downstate. These five regions were compared according to median charge and cost per day.
  
  
  RESULTS
  From 2008 to 2011, 1803 transsphenoidal pituitary tumor surgeries were performed in New York State. Mean patient age was 50.7 years (54 % were female). Adjusting prices for length of stay, there was substantial variation in prices. Median charges per day ranged from $8485 to $13,321 and median costs per day ranged from $2962 to $6837 between the highest and lowest regions from 2008 to 2011.
  
  
  CONCLUSIONS
  Within New York State, significant geographic variation exists in the cost for transsphenoidal pituitary surgery. The significance of and contributors to such variation is an important question for patients, providers, and policy makers. Transparency of hospital charges, costs, and average length of stay for procedures to the public provides useful information for informed decision-making, especially for a highly portable disease entity like pituitary tumors.
authors: Department of Neurosurgery, School of Medicine and Dentistry, University of Rochester Medical Center, 601 Elmwood Ave, Box 670, Rochester, NY, 14642, USA. Charles_Lee@urmc.rochester.edu.|UR Medicine Pituitary Program, University of Rochester Medical Center, 601 Elmwood Ave, Box 670, Rochester, NY, 14642, USA. Charles_Lee@urmc.rochester.edu.
authors: Charles C
authors: CC
authors: Lee
authors: Department of Neurosurgery, School of Medicine and Dentistry, University of Rochester Medical Center, 601 Elmwood Ave, Box 670, Rochester, NY, 14642, USA.
authors: Kristopher T
authors: KT
authors: Kimmell
authors: Department of Biostatistics and Computational Biology, University of Rochester Medical Center, 601 Elmwood Ave, Box 630, Rochester, NY, 14642, USA.
authors: Amy
authors: A
authors: Lalonde
authors: Department of Biostatistics and Computational Biology, University of Rochester Medical Center, 601 Elmwood Ave, Box 630, Rochester, NY, 14642, USA.
authors: Peter
authors: P
authors: Salzman
authors: Department of Otolaryngology, University of Rochester Medical Center, 601 Elmwood Ave, Box 629, Rochester, NY, 14642, USA.
authors: Matthew C
authors: MC
authors: Miller
authors: Division of Endocrine, Diabetes, and Metabolism, University of Rochester Medical Center, 601 Elmwood Ave, Box 693, Rochester, NY, 14642, USA.|UR Medicine Pituitary Program, University of Rochester Medical Center, 601 Elmwood Ave, Box 670, Rochester, NY, 14642, USA.
authors: Laura M
authors: LM
authors: Calvi
authors: Division of Endocrine, Diabetes, and Metabolism, University of Rochester Medical Center, 601 Elmwood Ave, Box 693, Rochester, NY, 14642, USA.|UR Medicine Pituitary Program, University of Rochester Medical Center, 601 Elmwood Ave, Box 670, Rochester, NY, 14642, USA.
authors: Ekaterina
authors: E
authors: Manuylova
authors: Division of Endocrine, Diabetes, and Metabolism, University of Rochester Medical Center, 601 Elmwood Ave, Box 693, Rochester, NY, 14642, USA.|UR Medicine Pituitary Program, University of Rochester Medical Center, 601 Elmwood Ave, Box 670, Rochester, NY, 14642, USA.
authors: Ismat
authors: I
authors: Shafiq
authors: Department of Neurosurgery, School of Medicine and Dentistry, University of Rochester Medical Center, 601 Elmwood Ave, Box 670, Rochester, NY, 14642, USA.|Department of Otolaryngology, University of Rochester Medical Center, 601 Elmwood Ave, Box 629, Rochester, NY, 14642, USA.|Division of Endocrine, Diabetes, and Metabolism, University of Rochester Medical Center, 601 Elmwood Ave, Box 693, Rochester, NY, 14642, USA.|UR Medicine Pituitary Program, University of Rochester Medical Center, 601 Elmwood Ave, Box 670, Rochester, NY, 14642, USA.
authors: G
authors: G
authors: Edward Vates
mesh_terms: D000328:Adult; D000368:Aged; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D019635:Neurosurgical Procedures / Q000191:economics*; D009518:New York; D010911:Pituitary Neoplasms / Q000601:surgery*
keywords: Charges; Costs; Geographic variation; Pituitary tumor surgery