Procedural outcomes of deep brain stimulation (DBS) surgery in rural and urban patient population settings

J Clin Neurosci. 2020 Feb:72:310-315. doi: 10.1016/j.jocn.2019.08.117. Epub 2019 Sep 3.

Abstract

Presently, disparities exist between race, sex, socioeconomic status, hospitals, income, comorbidities, and insurance profiles of patients undergoing DBS surgery. Here, we aim to highlight several variables and their predictive powers of DBS surgery outcomes as measured by dischargelocation, length of hospital stays, and total hospital charges. A retrospective cohort study using discharge data from NIS and HCUP for analyses and regression model statistics is performed. Comparative analyses demonstrate urban patients were more often non-routinely discharged, possessed private insurance, and accrued greater hospital costs compared to rural patients. Moreover, regression analyses predicts urban patients have 70% lower odds of routine discharge while those with a major loss of function prior to surgery also have 81% lower odds of routine discharge compared to those with minor loss of function. Ultimately, our study found urban patients or patients with major illnesses have higher hospital charges, longer hospitalization, and more often non-routinely discharged.

Keywords: Deep brain stimulation; Hospital costs; Hospital stay; Routine disposition; Rural patients; Urban patients.

MeSH terms

  • Adult
  • Aged
  • Deep Brain Stimulation / economics
  • Deep Brain Stimulation / statistics & numerical data*
  • Female
  • Healthcare Disparities / economics
  • Healthcare Disparities / statistics & numerical data*
  • Hospital Charges / statistics & numerical data
  • Hospital Costs / statistics & numerical data
  • Humans
  • Length of Stay / statistics & numerical data
  • Male
  • Middle Aged
  • Patient Discharge / statistics & numerical data
  • Rural Population / statistics & numerical data*
  • United States
  • Urban Population / statistics & numerical data*