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dc.contributor.authorJacobs, Karel
dc.contributor.authorDewilde, Thibault
dc.contributor.authorVandoren, Cindy
dc.contributor.authorCardoen, Brecht
dc.contributor.authorVansteenkiste, Nancy
dc.contributor.authorScheys, Lennart
dc.contributor.authorRoodhooft, Filip
dc.contributor.authorMoke, Lieven
dc.contributor.authorKesteloot, Katrien
dc.date.accessioned2020-08-28T07:32:08Z
dc.date.available2020-08-28T07:32:08Z
dc.date.issued2020en_US
dc.identifier.issn0362-2436
dc.identifier.doi10.1097/BRS.0000000000003497
dc.identifier.urihttp://hdl.handle.net/20.500.12127/6532
dc.description.abstractObjective: To calculate the total clinical hospital cost of the Adult Spinal Deformity (ASD) care trajectory, to explain cost variability by patient and surgery characteristics, and to identify areas of process improvement opportunities. Summary of background data: ASD is associated with a high financial and clinical burden on society. ASD care thus requires improved insights in costs and its drivers as a critical step toward the improvement of value, i.e., the ratio between delivered health outcome and associated costs. Methods: Patient characteristics and surgical variables were collected following ethical approval in a cohort of 139 ASD patients, treated between December, 2014 and January, 2018. Clinical hospital costs were calculated, including all care activities, from initial consultation to 1 year after initial surgery (excl. overhead) in a university hospital setting. Multiple linear regression analysis was performed to analyze the impact of patient and surgical characteristics on clinical costs. Results: 75.5% of the total clinical hospital cost (€27,865) was incurred during initial surgery with costs related to the operating theatre (80.3%), nursing units (11.9%), and intensive care (2.9%) being the largest contributors. 57.5% of the variation in total cost could be explained in order of importance by surgical invasiveness, age, coronary disease, single or multiple-staged surgery, and mobility status. Revision surgery, unplanned surgery due to complications, was found to increase average costs by 87.6% compared with elective surgeries (€ 44,907 (± € 23,429) vs. € 23,944 (± € 7302)). Conclusion: This study identified opportunities for process improvement by calculating the total clinical hospital costs. In addition, it identified patient and treatment characteristics that predict 57.5% of cost variation, which could be taken into account when developing a payment system. Future research should include outcome data to assess variation in value.en_US
dc.language.isoenen_US
dc.publisherLippincott, Williams & Wilkinsen_US
dc.rights.urihttps://creativecommons.org/licenses/by-nc-nd/4.0/
dc.subjectHospital Costsen_US
dc.subjectASDen_US
dc.subjectSingle-Center Analysisen_US
dc.subjectRetrospectiveen_US
dc.titleVariability in hospital costs of adult spinal deformity careen_US
refterms.dateFOA2020-09-13T19:30:14Z
dc.identifier.journalSpineen_US
dc.source.volume45en_US
dc.source.issue17en_US
dc.source.beginpage1221en_US
dc.source.endpage1228en_US
dc.contributor.departmentUniversity Hospitals Leuven, Leuven, Belgiumen_US
dc.contributor.departmentKU Leuven, Faculty of Medicine, LIGB (Leuven Institute for Health Policy), Leuven, Belgiumen_US
dc.contributor.departmentKU Leuven, Faculty of Medicine, Institute for Orthopaedic Research and Training, Leuven, Belgiumen_US
dc.contributor.departmentKU Leuven, Faculty of Economics and Business, Center for Operations Management, Leuven, Belgiumen_US
dc.contributor.departmentKU Leuven, Faculty of Economics and Business, Research Centre Accountancy, Leuven, Belgiumen_US
dc.identifier.eissn1528-1159
vlerick.knowledgedomainAccounting & Financeen_US
vlerick.knowledgedomainOperations & Supply Chain Managementen_US
vlerick.typearticleJournal article with impact factoren_US
vlerick.vlerickdepartmentAFen_US
vlerick.vlerickdepartmentTOMen_US
dc.identifier.vperid182153en_US
dc.identifier.vperid120992en_US
dc.identifier.vperid51506en_US


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