Economic Impact of Hospitalization Past Maximal Neurosurgical Inpatient Benefit

Area of Science:

• Healthcare Economics
• Neurosurgery
• Hospital Administration

Background:

• Unsustainable healthcare costs necessitate examining wasteful spending in all medical practices.
• Prolonged hospitalizations beyond maximum inpatient benefit represent a significant source of economic waste.

Purpose of the Study:

• To determine the direct and indirect costs of prolonged neurosurgical hospitalizations.
• To identify targets for mitigating healthcare economic waste in neurosurgery.

Main Methods:

• Retrospective chart review of neurosurgery patients admitted between July and October 2016.
• Analysis of patient factors, procedural acuity, disposition, and funding contributing to discharge delays.
• Identification of patients deemed medically stable but remaining hospitalized past their ideal discharge date.

Main Results:

• 15% of neurosurgery admissions (50 patients) experienced medically unnecessary prolonged hospitalizations (324 days total).
• Elective cases had the most prolonged hospitalizations; emergent cases had the most prolonged days.
• Discharge delays were linked to external facility bed availability, funding, and disposition disagreements. Medically unnecessary days constituted 41% of total hospitalization but only 12.9% of charges, with a cost of $2,070/day vs. $17,326/day for necessary days.

Conclusions:

• Neurosurgical patients hospitalized past maximum benefit incur substantial economic impact.
• Identifying at-risk patients for prolonged stays is crucial for waste mitigation.
• Addressing discharge barriers can optimize hospital resource allocation and reduce healthcare costs.