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<meta name="DC.Title" content="Comparative Hospital Economics and Patient Presentation: Vertebroplasty and Kyphoplasty for the Treatment of Vertebral Compression Fracture" />
<meta name="DC.Identifier" content="10.3174/ajnr.A2502" />
<meta name="DC.Date" content="2011-08-01" />
<meta name="DC.Publisher" content="American Journal of Neuroradiology" />
<meta name="DC.Rights" content="Copyright © American Society of Neuroradiology. 
Indicates open access to non-subscribers at www.ajnr.org" />
<meta name="DC.AccessRights" content="open-access" />
<meta name="DC.Description" content="BACKGROUND AND PURPOSE: Previous studies evaluating vertebral augmentation procedure costs have not made detailed comparisons between vertebroplasty and kyphoplasty. Our study contrasts hospital costs for vertebroplasty versus kyphoplasty for the treatment of vertebral compression fractures in routine clinical practice in the United States.

MATERIALS AND METHODS: This retrospective cohort study analyzed 2007–2008 hospital discharge and billing records from the Premier Perspective data base. The primary outcome variable, differences in total hospital cost between vertebroplasty and kyphoplasty, was assessed by using analysis of covariance.

RESULTS: Three thousand six hundred seventeen patients received vertebroplasty (64% inpatient, 36% outpatient), and 8118 received kyphoplasty (54% inpatient, 46% outpatient). Approximately 75% were women, and most were white. Mean total unadjusted inpatient costs were $9837 for vertebroplasty versus $13 187 for kyphoplasty ( P &lt; .0001). Outpatient vertebroplasty costs were $3319 versus $8100 for kyphoplasty ( P &lt; .0001). Lower vertebroplasty costs were largely due to differences in hospital supply and OR. Mean vertebroplasty OR costs were $73.60 (anesthesia), $112.06 (recovery room), and $990.12 (surgery) versus $172.16 (anesthesia), $257.47 (recovery room), and $1,471.49 (surgery) with kyphoplasty. Adjustments for age, sex, admission status, and disease severity accentuated the differences. Mean adjusted inpatient costs were $11 386 for vertebroplasty versus $16 182 for kyphoplasty ( P &lt; .0001), and outpatient costs were $2997 for vertebroplasty versus $7010 for kyphoplasty ( P &lt; .0001). After adjustments for the same covariates, length-of-stay differences were no longer evident ( P = .4945).

CONCLUSIONS: Performing vertebroplasty versus kyphoplasty reduces hospital costs by nearly $5000 for inpatient procedures and by more than $4000 for outpatient procedures.

APR
:   all-patient refined
CAP
:   capitated
CPT
:   Current Procedural Terminology
DRG
:   diagnosis related group
ICD-9-CM
:   International Classification of Diseases, ninth revision, Clinical Modification
NA
:   not applicable
OR
:   operating room
VAP
:   vertebral augmentation procedure
VCF
:   vertebral compression fracture" />
<meta name="DC.Contributor" content="A.K. Mehio" />
<meta name="DC.Contributor" content="J.H. Lerner" />
<meta name="DC.Contributor" content="L.M. Engelhart" />
<meta name="DC.Contributor" content="C.M. Kozma" />
<meta name="DC.Contributor" content="T.L. Slaton" />
<meta name="DC.Contributor" content="N.C. Edwards" />
<meta name="DC.Contributor" content="G.J. Lawler" />
<meta name="article:published_time" content="2011-08-01" />
<meta name="article:section" content="Spine" />
<meta name="citation_title" content="Comparative Hospital Economics and Patient Presentation: Vertebroplasty and Kyphoplasty for the Treatment of Vertebral Compression Fracture" />
<meta name="citation_abstract" lang="en" content="&lt;h3&gt;BACKGROUND AND PURPOSE:&lt;/h3&gt;
&lt;p&gt;Previous studies evaluating vertebral augmentation procedure costs have not made detailed comparisons between vertebroplasty and kyphoplasty. Our study contrasts hospital costs for vertebroplasty versus kyphoplasty for the treatment of vertebral compression fractures in routine clinical practice in the United States.&lt;/p&gt;&lt;h3&gt;MATERIALS AND METHODS:&lt;/h3&gt;
&lt;p&gt;This retrospective cohort study analyzed 2007–2008 hospital discharge and billing records from the Premier Perspective data base. The primary outcome variable, differences in total hospital cost between vertebroplasty and kyphoplasty, was assessed by using analysis of covariance.&lt;/p&gt;&lt;h3&gt;RESULTS:&lt;/h3&gt;
&lt;p&gt;Three thousand six hundred seventeen patients received vertebroplasty (64% inpatient, 36% outpatient), and 8118 received kyphoplasty (54% inpatient, 46% outpatient). Approximately 75% were women, and most were white. Mean total unadjusted inpatient costs were $9837 for vertebroplasty versus $13 187 for kyphoplasty (&lt;i&gt;P&lt;/i&gt; &amp;lt; .0001). Outpatient vertebroplasty costs were $3319 versus $8100 for kyphoplasty (&lt;i&gt;P&lt;/i&gt; &amp;lt; .0001). Lower vertebroplasty costs were largely due to differences in hospital supply and OR. Mean vertebroplasty OR costs were $73.60 (anesthesia), $112.06 (recovery room), and $990.12 (surgery) versus $172.16 (anesthesia), $257.47 (recovery room), and $1,471.49 (surgery) with kyphoplasty. Adjustments for age, sex, admission status, and disease severity accentuated the differences. Mean adjusted inpatient costs were $11 386 for vertebroplasty versus $16 182 for kyphoplasty (&lt;i&gt;P&lt;/i&gt; &amp;lt; .0001), and outpatient costs were $2997 for vertebroplasty versus $7010 for kyphoplasty (&lt;i&gt;P&lt;/i&gt; &amp;lt; .0001). After adjustments for the same covariates, length-of-stay differences were no longer evident (&lt;i&gt;P&lt;/i&gt; = .4945).&lt;/p&gt;&lt;h3&gt;CONCLUSIONS:&lt;/h3&gt;
&lt;p&gt;Performing vertebroplasty versus kyphoplasty reduces hospital costs by nearly $5000 for inpatient procedures and by more than $4000 for outpatient procedures.&lt;/p&gt;" />
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<meta name="twitter:title" content="Comparative Hospital Economics and Patient Presentation: Vertebroplasty and Kyphoplasty for the Treatment of Vertebral Compression Fracture" />
<meta name="twitter:card" content="summary_large_image" />
<meta name="twitter:image" content="http://ajnr-stage2.stage.highwire.org/sites/default/files/highwire/ajnr/32/7.cover.gif" />
<meta name="twitter:description" content="BACKGROUND AND PURPOSE: Previous studies evaluating vertebral augmentation procedure costs have not made detailed comparisons between vertebroplasty and kyphoplasty. Our study contrasts hospital costs for vertebroplasty versus kyphoplasty for the treatment of vertebral compression fractures in routine clinical practice in the United States.

MATERIALS AND METHODS: This retrospective cohort study analyzed 2007–2008 hospital discharge and billing records from the Premier Perspective data base. The primary outcome variable, differences in total hospital cost between vertebroplasty and kyphoplasty, was assessed by using analysis of covariance.

RESULTS: Three thousand six hundred seventeen patients received vertebroplasty (64% inpatient, 36% outpatient), and 8118 received kyphoplasty (54% inpatient, 46% outpatient). Approximately 75% were women, and most were white. Mean total unadjusted inpatient costs were $9837 for vertebroplasty versus $13 187 for kyphoplasty ( P &lt; .0001). Outpatient vertebroplasty costs were $3319 versus $8100 for kyphoplasty ( P &lt; .0001). Lower vertebroplasty costs were largely due to differences in hospital supply and OR. Mean vertebroplasty OR costs were $73.60 (anesthesia), $112.06 (recovery room), and $990.12 (surgery) versus $172.16 (anesthesia), $257.47 (recovery room), and $1,471.49 (surgery) with kyphoplasty. Adjustments for age, sex, admission status, and disease severity accentuated the differences. Mean adjusted inpatient costs were $11 386 for vertebroplasty versus $16 182 for kyphoplasty ( P &lt; .0001), and outpatient costs were $2997 for vertebroplasty versus $7010 for kyphoplasty ( P &lt; .0001). After adjustments for the same covariates, length-of-stay differences were no longer evident ( P = .4945).

CONCLUSIONS: Performing vertebroplasty versus kyphoplasty reduces hospital costs by nearly $5000 for inpatient procedures and by more than $4000 for outpatient procedures.

APR
:   all-patient refined
CAP
:   capitated
CPT
:   Current Procedural Terminology
DRG
:   diagnosis related group
ICD-9-CM
:   International Classification of Diseases, ninth revision, Clinical Modification
NA
:   not applicable
OR
:   operating room
VAP
:   vertebral augmentation procedure
VCF
:   vertebral compression fracture" />
<meta name="og-title" property="og:title" content="Comparative Hospital Economics and Patient Presentation: Vertebroplasty and Kyphoplasty for the Treatment of Vertebral Compression Fracture" />
<meta name="og-url" property="og:url" content="http://ajnr-stage2.stage.highwire.org/content/32/7/1290" />
<meta name="og-site-name" property="og:site_name" content="American Journal of Neuroradiology" />
<meta name="og-description" property="og:description" content="BACKGROUND AND PURPOSE: Previous studies evaluating vertebral augmentation procedure costs have not made detailed comparisons between vertebroplasty and kyphoplasty. Our study contrasts hospital costs for vertebroplasty versus kyphoplasty for the treatment of vertebral compression fractures in routine clinical practice in the United States.

MATERIALS AND METHODS: This retrospective cohort study analyzed 2007–2008 hospital discharge and billing records from the Premier Perspective data base. The primary outcome variable, differences in total hospital cost between vertebroplasty and kyphoplasty, was assessed by using analysis of covariance.

RESULTS: Three thousand six hundred seventeen patients received vertebroplasty (64% inpatient, 36% outpatient), and 8118 received kyphoplasty (54% inpatient, 46% outpatient). Approximately 75% were women, and most were white. Mean total unadjusted inpatient costs were $9837 for vertebroplasty versus $13 187 for kyphoplasty ( P &lt; .0001). Outpatient vertebroplasty costs were $3319 versus $8100 for kyphoplasty ( P &lt; .0001). Lower vertebroplasty costs were largely due to differences in hospital supply and OR. Mean vertebroplasty OR costs were $73.60 (anesthesia), $112.06 (recovery room), and $990.12 (surgery) versus $172.16 (anesthesia), $257.47 (recovery room), and $1,471.49 (surgery) with kyphoplasty. Adjustments for age, sex, admission status, and disease severity accentuated the differences. Mean adjusted inpatient costs were $11 386 for vertebroplasty versus $16 182 for kyphoplasty ( P &lt; .0001), and outpatient costs were $2997 for vertebroplasty versus $7010 for kyphoplasty ( P &lt; .0001). After adjustments for the same covariates, length-of-stay differences were no longer evident ( P = .4945).

CONCLUSIONS: Performing vertebroplasty versus kyphoplasty reduces hospital costs by nearly $5000 for inpatient procedures and by more than $4000 for outpatient procedures.

APR
:   all-patient refined
CAP
:   capitated
CPT
:   Current Procedural Terminology
DRG
:   diagnosis related group
ICD-9-CM
:   International Classification of Diseases, ninth revision, Clinical Modification
NA
:   not applicable
OR
:   operating room
VAP
:   vertebral augmentation procedure
VCF
:   vertebral compression fracture" />
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    <div class="highwire-article-citation highwire-citation-type-highwire-article node11414--5" data-node-nid="11414" id="top-node-11414--6216028395" data-pisa="ajnr;32/7/1290" data-pisa-master="ajnr;ajnr.A2502" data-apath="/ajnr/32/7/1290.atom" data-hw-author-tooltip-instance="highwire_author_tooltip"><div class="highwire-cite highwire-cite-highwire-article highwire-citation-jcore-article-title-complete clearfix has-author-tooltip highwire-citation-highwire-article-top-a">
  
  
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      <h1 class="highwire-cite-title" id="page-title">Comparative Hospital Economics and Patient Presentation: Vertebroplasty and Kyphoplasty for the Treatment of Vertebral Compression Fracture</h1>  
    	<div class="highwire-cite-authors"><span  class="highwire-citation-authors"><span class="highwire-citation-author first" data-delta="0">A.K. Mehio</span>, <span class="highwire-citation-author" data-delta="1">J.H. Lerner</span>, <span class="highwire-citation-author" data-delta="2">L.M. Engelhart</span>, <span class="highwire-citation-author" data-delta="3">C.M. Kozma</span>, <span class="highwire-citation-author" data-delta="4">T.L. Slaton</span>, <span class="highwire-citation-author" data-delta="5">N.C. Edwards</span> and <span class="highwire-citation-author" data-delta="6">G.J. Lawler</span></span></div>
  
    	<div class="highwire-cite-metadata"><span  class="highwire-cite-metadata-journal highwire-cite-metadata">American Journal of Neuroradiology </span><span  class="highwire-cite-metadata-date highwire-cite-metadata">August 2011,  </span><span  class="highwire-cite-metadata-volume highwire-cite-metadata">32 </span><span  class="highwire-cite-metadata-issue highwire-cite-metadata">(7) </span><span  class="highwire-cite-metadata-pages highwire-cite-metadata">1290-1294; </span><span  class="highwire-cite-metadata-doi highwire-cite-metadata">DOI: https://doi.org/10.3174/ajnr.A2502 </span></div>
  
  
  
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<div id="hw-article-author-popups-top-node-11414--6216028395" style="display: none;"><div class="author-tooltip-0"><div class="author-tooltip-name">A.K. Mehio </div><ul class="author-tooltip-find-more"><li class="author-tooltip-gs-link first"><a href="/lookup/google-scholar?link_type=googlescholar&amp;gs_type=author&amp;author%5B0%5D=A.K.%2BMehio%2B" target="_blank" class="" data-icon-position="" data-hide-link-title="0">Find this author on Google Scholar</a></li><li class="author-tooltip-pubmed-link"><a href="/lookup/external-ref?access_num=Mehio%20A&amp;link_type=AUTHORSEARCH" target="_blank" class="" data-icon-position="" data-hide-link-title="0">Find this author on PubMed</a></li><li class="author-site-search-link last"><a href="/search/author1%3AA.K.%2BMehio%2B" rel="nofollow" class="" data-icon-position="" data-hide-link-title="0">Search for this author on this site</a></li></ul></div><div class="author-tooltip-1"><div class="author-tooltip-name">J.H. 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Kozma </div><ul class="author-tooltip-find-more"><li class="author-tooltip-gs-link first"><a href="/lookup/google-scholar?link_type=googlescholar&amp;gs_type=author&amp;author%5B0%5D=C.M.%2BKozma%2B" target="_blank" class="" data-icon-position="" data-hide-link-title="0">Find this author on Google Scholar</a></li><li class="author-tooltip-pubmed-link"><a href="/lookup/external-ref?access_num=Kozma%20C&amp;link_type=AUTHORSEARCH" target="_blank" class="" data-icon-position="" data-hide-link-title="0">Find this author on PubMed</a></li><li class="author-site-search-link last"><a href="/search/author1%3AC.M.%2BKozma%2B" rel="nofollow" class="" data-icon-position="" data-hide-link-title="0">Search for this author on this site</a></li></ul></div><div class="author-tooltip-4"><div class="author-tooltip-name">T.L. 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Edwards </div><ul class="author-tooltip-find-more"><li class="author-tooltip-gs-link first"><a href="/lookup/google-scholar?link_type=googlescholar&amp;gs_type=author&amp;author%5B0%5D=N.C.%2BEdwards%2B" target="_blank" class="" data-icon-position="" data-hide-link-title="0">Find this author on Google Scholar</a></li><li class="author-tooltip-pubmed-link"><a href="/lookup/external-ref?access_num=Edwards%20N&amp;link_type=AUTHORSEARCH" target="_blank" class="" data-icon-position="" data-hide-link-title="0">Find this author on PubMed</a></li><li class="author-site-search-link last"><a href="/search/author1%3AN.C.%2BEdwards%2B" rel="nofollow" class="" data-icon-position="" data-hide-link-title="0">Search for this author on this site</a></li></ul></div><div class="author-tooltip-6"><div class="author-tooltip-name">G.J. 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    <div class="highwire-markup"><div xmlns="http://www.w3.org/1999/xhtml" xmlns:xhtml="http://www.w3.org/1999/xhtml" class="section ref-list" id="ref-list-1"><h2>References</h2><ol class="cit-list ref-use-labels"><li><span class="ref-label">1.</span><a class="rev-xref-ref" href="#xref-ref-1-1" title="View reference 1. in text" id="ref-1">↵</a>

<div class="cit ref-cit ref-journal" id="cit-32.7.1290.1" data-doi="10.1016/j.injury.2007.08.016"><div class="cit-metadata"><ol class="cit-auth-list"><li><span class="cit-auth"><span class="cit-name-surname">Barrocas</span>  <span class="cit-name-given-names">AM</span></span>, </li><li><span class="cit-auth"><span class="cit-name-surname">Eskey</span>  <span class="cit-name-given-names">CJ</span></span>, </li><li><span class="cit-auth"><span class="cit-name-surname">Hirsch</span>  <span class="cit-name-given-names">JA</span></span></li></ol><cite>. <span class="cit-article-title">Vertebral augmentation in osteoporotic fractures</span>. <abbr class="cit-jnl-abbrev">Injury</abbr> <span class="cit-pub-date">2007</span>;<span class="cit-vol">38</span>(<span class="cit-supplement">suppl 3</span>):<span class="cit-fpage">S88</span>–<span class="cit-lpage">96</span></cite></div><div class="cit-extra"><a href="/lookup/external-ref?access_num=10.1016/j.injury.2007.08.016&amp;link_type=DOI" class="cit-ref-sprinkles cit-ref-sprinkles-doi cit-ref-sprinkles-crossref"><span>CrossRef</span></a><a href="/lookup/external-ref?access_num=17723797&amp;link_type=MED&amp;atom=%2Fajnr%2F32%2F7%2F1290.atom" class="cit-ref-sprinkles cit-ref-sprinkles-medline"><span>PubMed</span></a></div></div></li><li><span class="ref-label">2.</span><a class="rev-xref-ref" href="#xref-ref-2-1" title="View reference 2. in text" id="ref-2">↵</a>

<div class="cit ref-cit ref-journal" id="cit-32.7.1290.2" data-doi="10.1016/j.injury.2007.08.010"><div class="cit-metadata"><ol class="cit-auth-list"><li><span class="cit-auth"><span class="cit-name-surname">Prather</span>  <span class="cit-name-given-names">H</span></span>, </li><li><span class="cit-auth"><span class="cit-name-surname">Watson</span>  <span class="cit-name-given-names">JO</span></span>, </li><li><span class="cit-auth"><span class="cit-name-surname">Gilula</span>  <span class="cit-name-given-names">LA</span></span></li></ol><cite>. <span class="cit-article-title">Nonoperative management of osteoporotic vertebral compression fractures</span>. <abbr class="cit-jnl-abbrev">Injury</abbr> <span class="cit-pub-date">2007</span>;<span class="cit-vol">38</span>(<span class="cit-supplement">suppl 3</span>):<span class="cit-fpage">S40</span>–<span class="cit-lpage">48</span></cite></div><div class="cit-extra"><a href="/lookup/external-ref?access_num=10.1016/j.injury.2007.08.010&amp;link_type=DOI" class="cit-ref-sprinkles cit-ref-sprinkles-doi cit-ref-sprinkles-crossref"><span>CrossRef</span></a><a href="/lookup/external-ref?access_num=17723791&amp;link_type=MED&amp;atom=%2Fajnr%2F32%2F7%2F1290.atom" class="cit-ref-sprinkles cit-ref-sprinkles-medline"><span>PubMed</span></a></div></div></li><li><span class="ref-label">3.</span><a class="rev-xref-ref" href="#xref-ref-3-1" title="View reference 3. in text" id="ref-3">↵</a>

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        	<div class="highwire-cite-metadata"><span  class="highwire-cite-metadata-volume highwire-cite-metadata">Vol. 32</span>, <span  class="highwire-cite-metadata-issue highwire-cite-metadata">Issue 7 </span><div  class="highwire-cite-metadata-pubdate highwire-cite-metadata">1 Aug 2011 </div></div>
      
      
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    	<div class="highwire-cite-metadata"><span  class="highwire-cite-metadata-oa-ind highwire-cite-metadata"><i class="highwire-oa-indicator"></i> </span><span  class="highwire-cite-metadata-journal highwire-cite-metadata">American Journal of Neuroradiology </span><span  class="highwire-cite-metadata-date highwire-cite-metadata">Aug 2011, </span><span  class="highwire-cite-metadata-volume highwire-cite-metadata">32 </span><span  class="highwire-cite-metadata-issue highwire-cite-metadata">(7) </span><span  class="highwire-cite-metadata-pages highwire-cite-metadata">1290-1294; </span><span  class="highwire-cite-metadata-doi highwire-cite-metadata"><span class="label">DOI:</span> 10.3174/ajnr.A2502 </span></div>
  
  
  
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