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Post-kyphoplasty length of stay 80% shorter than with conservative treatment
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Patients with osteoporotic vertebral compression fractures treated by balloon kyphoplasty had fewer inpatient follow-up visits and lower overall treatment costs than those treated conservatively, results of a retrospective study conducted in Austria showed.
“The follow-up of osteoporotic vertebral fractures treated with balloon kyphoplasty vs. conservative treatment was cheaper, shorter and less frequent,” Stephan W.J. Becker, MD, said at a recent meeting.
An economic analysis of the inpatient costs for treating osteoporotic vertebral compression fractures (VCF) detected a difference of $888, or 678 Euros, between the two groups’ costs for inpatient follow-up care based on value points the Austrian government assigns to diagnostic-related groups (DRGs) for reimbursement purposes.
Overall costs tended to be lower in patients treated with balloon kyphoplasty, Becker said.
Database information
Using the database at a large Austrian hospital, investigators identified 111 patients who received conservative treatment and 140 patients who underwent balloon kyphoplasty surgery for VCFs between Jan. 1, 2002 and Dec. 31, 2005.
Using other hospital databases and the Austrian national DRG point system, investigators identified all inpatient treatments these patients received in Austrian hospitals through 2006.
The search revealed mortality rates from various causes of 9.9% and 6.4% in the conservative and kyphoplasty groups, respectively, but no difference between the groups’ ages.
DRG points
Concerning nationwide inpatient DRG codes for the study groups, investigators assessed the number of admissions, length of stay per admission and total DRG value points for the study period. DRG codes in Austria are assigned monetary values that vary among hospitals, cities and regions. One DRG point equals approximately 1 Euro, Becker told Orthopaedics Today Europe.
Patients’ DRG scores increased the more DRG treatment points they earned. They also had higher overall treatment costs, he noted.
The conservative group had total admissions of 195 vs. 109 in the balloon kyphoplasty group. Patients treated primarily with balloon kyphoplasty had about 51% fewer spine-related admissions each study year for back pain, recurrent fractures or operative treatments, based on the DRGs, Becker said.
Inpatient stays
The follow-up inpatient stays per patient per observation year were 3.34 for the conservative group and 0.6 for the kyphoplasty group (P = 0.004), about an 80% difference.
DRG treatment points per patient totaled 3,824 in the conservative group and 3,146 in the balloon kyphoplasty group for an overall difference of 678 DRG points between the groups’ follow-up care costs for VCFs, he added.
- Reference:
Becker SW, Pfeiffer K-P, Ogon M. Evaluation of the treatment costs after balloon kyphoplasty vs. conservative treatment in osteoporotic vertebral fractures — An economical analysis. Paper #F318. Presented at the 10th EFORT Congress. June 3-6, 2009. Vienna.
