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MIPS for Intracerebral Hemorrhage Decreases Length of ICU Stay Without Alteration in Overall Cost

Neurosurgery, 2020-12, Vol.67 (Supplement_1) [Peer Reviewed Journal]

Copyright © 2020 by the Congress of Neurological Surgeons 2020 ;Copyright © 2020 by the Congress of Neurological Surgeons ;ISSN: 0148-396X ;EISSN: 1524-4040 ;DOI: 10.1093/neuros/nyaa447_355

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  • Title:
    MIPS for Intracerebral Hemorrhage Decreases Length of ICU Stay Without Alteration in Overall Cost
  • Author: Johnson, Kendrick ; Buishas, Joel ; Tsung, Andrew J ; Spence, Sean
  • Subjects: Cost control ; Neurosurgery ; Surgical techniques
  • Is Part Of: Neurosurgery, 2020-12, Vol.67 (Supplement_1)
  • Description: Abstract INTRODUCTION MIPS has been shown to be a safe and effective approach to deep seated cerebral hemorrhages. METHODS Group 1 patients were ENRICH trial eligible and underwent MIPS procedure plus standard medical care at a single center. Group 2 patients were also ENRICH trial eligible, however did not undergo surgical intervention and received standard medical care. RESULTS Two groups of 10 consecutively evaluated patients were studied; The mean Glasgow Coma Scale (GCS) score at initial evaluation was 12.6 in MIPS and 12.8 for the Conservative Group. There were 4 males in Group 1 and 3 in Group 2. Mean age in Group 1 was 55.7 and 59.3 years in Group 2. Mean ICH volume and depth were 30.2 cm3 and 1.24 cm in Group 1 and 36.94 cm3 and 0.806 cm in Group 2 respectively. The Average costs per day in ICU were significantly higher in the Surgical group vs the Conservative group (P = .013). However, overall ICU LOS was significantly lower in Group 1 vs Group 2 (P = 0.030). Other factors that did not prove to be significant in our study included Reimbursement (P = 1.73), Total direct cost (P = .44), and Total LOS (P = .11). In the MIPS group, mean reimbursement equaled $69,017 (two non-payers are excluded). In the Conservative group, mean reimbursement equaled $61,694. In the MIPS Group, 90% of the patients were discharged to IP Rehab, with the one remaining patient discharged to home with home-healthcare. In the Conservative treatment group 80% of the patients were discharged to either IP Rehab or Home (Home-health). The remaining 2 patients were discharged to a Skilled Nursing Facility. There were no 30-day readmission in MIPS Group and one 30-day readmission in the Conservatively treated group. CONCLUSION This is the first study to show that MIPS significantly decreased length of ICU admission, however this study did not find a significant improvement in cost savings or reimbursement. Further prospective studies will be needed to further elucidate potential cost saving measures.
  • Publisher: Philadelphia: Oxford University Press
  • Language: English
  • Identifier: ISSN: 0148-396X
    EISSN: 1524-4040
    DOI: 10.1093/neuros/nyaa447_355
  • Source: ProQuest Central
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