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Is intraoperative MRI use in malignant brain tumor surgery a health care burden? A matched analysis of MarketScan
Mayur Sharma1, Dengzhi Wang2, Paolo Palmisciano3
1Department of Neurosurgery, University of Louisville, 200 Abraham Flexner Hwy, Louisville, KY 40202, USA. mayur.sharma@uoflhealth.org.
Background:
Intraoperative magnetic resonance imaging (iMRI) is a useful adjunct for resection of primary malignant brain tumors (MBTs). The aim of our study is to investigate the impact of iMRI on health care utilization in patients who underwent craniotomy for resection of MBTs.
Materials And Methods:
MarketScan database were queried using the ICD-9/10 and CPT 4th edition, from 2008 to 2020. We included patients ≥ 18 years of age who underwent a craniotomy with at-least one year follow-up. Outcomes were length of stay (LOS), discharge disposition, hospital/emergency room (ER) re-admissions, outpatient services, medication refills and corresponding payments.
Results:
Of 6,640 patients who underwent craniotomy for MBTs, 465 patients (7%) had iMRI used during the procedure with 0.7% per year increase in iMRI use during the study period. Patients without iMRI use had higher complications at index hospitalization compared to those with iMRI use (19% vs. 14%, p = 0.04). There was no difference in the ER admission rates among the patients who underwent surgery with and without iMRI use at 6-months and 1-year after the index procedure. In terms of post-discharge payments, no significant differences were noted among the patients without and with iMRI use at 6-months ($81,107 vs. $ 81,458, p = 0.26) and 1-year ($132,657 vs. $ 118,113, p = 0.12).
Conclusion:
iMRI use during craniotomy for MBT gradually increased during the study period. iMRI did not result in higher payments at index hospitalization, 6-months, and 1-year after the index procedure.
Insights
Intraoperative MRI (iMRI) use for malignant brain tumor resection is increasing. This study found iMRI did not increase healthcare costs or readmissions, suggesting it is a cost-effective tool for brain tumor surgery.
Area of Science:
- Neurosurgery
- Oncology
- Health Economics
Background:
- Intraoperative magnetic resonance imaging (iMRI) is a valuable tool for resecting primary malignant brain tumors (MBTs).
- The study investigates the impact of iMRI on healthcare utilization following craniotomy for MBT resection.
Purpose of the Study:
- To assess the effect of iMRI on healthcare utilization in patients undergoing craniotomy for MBT resection.
- To analyze outcomes such as length of stay, readmissions, and healthcare payments.
Main Methods:
- Utilized the MarketScan database (2008-2020) with ICD-9/10 and CPT codes.
- Included adult patients (≥18 years) who underwent craniotomy for MBTs with at least one year of follow-up.
- Assessed outcomes including length of stay, discharge disposition, re-admissions, outpatient services, and payments.
Main Results:
- iMRI use increased by 0.7% annually, reaching 7% of 6,640 MBT resections.
- Patients without iMRI had higher index hospitalization complications (19% vs. 14%, p=0.04).
- No significant differences in ER readmissions or post-discharge payments at 6 months and 1 year were observed between iMRI and non-iMRI groups.
Conclusions:
- iMRI utilization for MBT craniotomy has steadily increased.
- iMRI use was not associated with increased healthcare payments at any measured time point.
- iMRI appears to be a cost-effective adjunct in malignant brain tumor surgery.
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Description of the Procedures
Computed Tomography (CT) scan:
Computed Tomography (CT) scans use X-ray technology to generate detailed images of bones, organs, and tissues. During the scan, the patient lies on a moving table...