J Neurol Res

Journal of Neurology Research, ISSN 1923-2845 print, 1923-2853 online, Open Access

Article copyright, the authors; Journal compilation copyright, J Neurol Res and Elmer Press Inc

Journal website http://www.neurores.org

Original Article

Volume 10, Number 4, August 2020, pages 122-126

Neurosurgical Economic and Readmission Trends After Extracranial Ventricular Shunts in the United States From 2009 to 2013

Figure

Figure 1. Clustered bar graph of Medicare and Medicaid index stays and readmissions after extracranial ventricular shunt (EVS) procedures annually from 2009 to 2013. The differences between the annual index stays and readmissions for Medicare (ME) and Medicaid (MD) patients requiring EVS were extremely statistically significant throughout the entire study period (P < 0.0001, P < 0.0001).

Tables

**Table 1.** Annual Mean Cost for Index Stays and Readmissions After EVS Procedures for Medicare and Medicaid Patients in US From 2009 to 2013
	2009	2010	2011	2012	2013
EVS: extracranial ventricular shunt.
Annual mean cost of all index stays	$36,811	$37,864	$42,746	$39,472	$38,829
Annual mean cost of all readmission	$19,005	$20,512	$21,076	$23,499	$22,303
Annual mean cost of Medicare index stays	$29,286	$30,417	$34,150	$32,735	$32,602
Annual mean cost of Medicare readmissions	$17,411	$19,856	$18,309	$19,522	$21,672
Annual mean cost of Medicaid index stays	$39,924	$40,609	$47,726	$44,192	$43,003
Annual mean cost of Medicaid readmissions	$19,856	$19,931	$22,762	$25,444	$24,270
P value for difference of index stays costs between Medicare and Medicaid patients after EVS	< 0.0001	< 0.0001	< 0.0001	< 0.0001	< 0.0001
P value for difference of readmissions costs between Medicare and Medicaid patients after EVS	< 0.0001	< 0.0001	< 0.0001	< 0.0001	< 0.0001

**Table 2.** Most Frequent Reasons for Readmissions Within 30 Days After EVS Procedures for Patients in US From 2009 to 2013*
	2009	2010	2011	2012	2013
*Percentage readmitted. EVS: extracranial ventricular shunt.
Complication of device, implant or graft	34.3	32.8	30.7	33.2	32.2
Complications of surgical procedures or medical care	5.5	6.2	6.0	4.0	6.5
Septicemia (except in labor)	-	4.0	4.3	5.6	5.7
Epilepsy, convulsions	-	-	3.5	4.7	-
Other hereditary and degenerative nervous system conditions	4.0	-	4.3	3.8
Acute cerebrovascular disease	3.2	4.0	-	-	-
Urinary tract infections	-	3.8	-	-	-
Other nervous system disorders	3.3	-	-	-	-