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Treating pediatric hydrocephalus in Australia: a 3-year hospital-based cost analysis and comparison with other
Alan Chuong Q Pham1, Christine Fan, Brian K Owler
1TY Nelson Department of Neurology and Neurosurgery, Children's Hospital at Westmead, New South Wales 2135, Australia. alan.chuong@gmail.com
Insights
Pediatric hydrocephalus treatment incurs significant costs, with shunt infections driving nearly half of expenditures. Effective long-term surgical strategies are crucial to reduce the economic burden on Australian hospitals.
Area of Science:
- Neurosurgery
- Pediatric Health Economics
Background:
- Hydrocephalus is a chronic neurological condition requiring surgical intervention.
- Pediatric hydrocephalus management presents a substantial economic challenge to healthcare systems.
Purpose of the Study:
- To quantify the financial costs associated with surgical interventions for pediatric hydrocephalus.
- To analyze the cost burden of newly diagnosed and treatment-failure hydrocephalus cases.
Main Methods:
- Retrospective analysis of hospital costs for shunt insertion, revision, infection treatment, and endoscopic third ventriculostomy (ETV).
- Data collected from 2007-2009 at the Children's Hospital at Westmead, Sydney.
- Exclusion of hydrocephalus cases secondary to trauma, malignancy, or other complex conditions.
Main Results:
- Total hydrocephalus-related costs amounted to $4.78 million (AUD) over three years.
- Shunt infections accounted for 40% of total costs, with an average admission cost of $83,649.
- Costs for shunt insertion and ETV were comparable, while shunt revision was less expensive per admission.
Conclusions:
- Hydrocephalus imposes a significant and increasing economic burden on the Australian hospital system.
- Seventy-five percent of expenditure is linked to managing complications or treatment failures.
- Further research into economic impact and effective long-term treatments is essential.
Object:
The aim of this study was to quantify the financial costs of surgical intervention in patients with newly diagnosed hydrocephalus and patients with treatment failure or complications of previously treated hydrocephalus between 2007 and 2009 at the Children's Hospital at Westmead in Sydney, Australia.
Methods:
This was a retrospective study of patients who underwent shunt insertion, shunt revision, treatment of an infected shunt, and endoscopic third ventriculostomy (ETV) between 2007 and 2009. Actual hospital costs associated with each inpatient stay were obtained from the accounting office of Children's Hospital at Westmead. Patients with hydrocephalus secondary to trauma, malignancy, or other complex conditions (except myelomeningocele) were excluded.
Results:
Hydrocephalus-related procedures comprised approximately one-third of neurosurgical procedures performed each year. From 2007 to 2009, there were 192 admissions during which 300 procedures were performed for 162 patients. The total cost was $4.78 million (Australian) with an average cost of $1.59 million per year. The cost per admission for shunt insertion and ETV were similar ($13,905 vs $14,128, respectively). The average cost per admission for shunt revision was $9,753. However, shunt infection was associated with 40% of total costs, averaging $83,649 per admission. Management of patients with myelomeningocele undergoing insertion of shunt procedures in the same admission accounted for an average cost of $50,186.
Conclusions:
Hydrocephalus is a chronic condition that imposes a significant and growing economic burden upon the Australian hospital system. Seventy-five percent of hydrocephalus-related hospital expenditure is used to surgically treat patients for complications or failure of previously treated hydrocephalus. Further research into the economic impact of pediatric hydrocephalus on the Australian health care system and concerted research efforts in the area of effective long-term surgical treatment and complication minimization are essential.
