@article{d0deed676c3a47b5ab1b9922e3fa398d,
title = "Healthcare Utilization and Costs for Patients With Parkinson's Disease After Deep Brain Stimulation",
abstract = "Objective: To compare the complications, healthcare utilization and costs following DBS or medical management for patients with Parkinson's disease (PD). Methods: We examined healthcare utilization and costs for up to 5 years between veterans with DBS and those with medical management for PD. Veterans who received DBS between 2007 and 2013 were matched with veterans who received medical management using propensity score approaches. Healthcare utilization and costs were obtained from national VA and Medicare data sources and compared using procedures to adjust for potential differences in length of follow-up. Results: We identified 611 veterans who had received DBS and a matched group of 611 veterans who did not undergo DBS. Among DBS patients, 59% had the electrodes and generator implanted during separate admissions. After 5 years of follow-up, average total healthcare costs, including DBS procedures and complications, were $77,131 (95% confidence interval: $66,095–$88,168; P < 0.001) higher per person for patients who received DBS ($162,489) than patients who received medical management ($85,358). In contrast, excluding the costs of the DBS procedures and complications, average total costs were not significantly different between patients who received DBS and patients who received medical management after 5 years of follow-up. Conclusions: Healthcare costs over 5 years were higher for veterans who received DBS. These higher healthcare costs may reflect the costs of DBS procedures and any follow-up required plus greater surveillance by healthcare professionals following DBS as well as unobserved differences in the patients who received medical management or DBS.",
keywords = "Parkinson's, cost, deep brain stimulation",
author = "Stroupe, {Kevin T.} and Bridget Smith and Weaver, {Frances M.} and Beverly Gonzalez and Zhiping Huo and Lishan Cao and Dolores Ippolito and Follett, {Kenneth A.}",
note = "Funding Information: Ethical Compliance Statement: This study was approved by the Edward Hines Jr. Institutional Review Board. A waiver of informed consent was obtained for this study. We confirm that we have read the Journal{\textquoteright}s position on issues involved in ethical publication and affirm that this work is consistent with those guidelines. Funding Sources and Conflicts of Interest: The funding source for study was Medtronic. Stroupe, Smith, Weaver, Gonzalez, Huo, Cao, and Ippolito report Medtronic Neurologic grant funding. Financial Disclosures for previous 12 months: Stroupe: Employment (Department of Veterans Affairs; Loyola University); Grants (Medtronic). Smith: Employment (Department of Veterans Affairs; Northwestern University); Grants (Medtronic). Weaver: Employment (Department of Veterans Affairs; Loyola University); Grants (Medtronic). Gonzalez: Employment (Department of Veterans Affairs); Grants (Medtronic). Huo: Employment (Department of Veterans Affairs); Grants (Medtronic). Cao: Employment (Department of Veterans Affairs); Grants (Medtronic). Ippolito: Employment (Department of Veterans Affairs); Grants (Medtronic). Follett: Employment (Department of Veterans Affairs; University of Nebraska). Funding Information: The reviews represented here are of the authors and do not necessarily reflect those of either the Veterans Health Administration nor Medtronic. Support for VA/CMS data is provided by the Department of Veterans Affairs, Veterans Health Administration, Office of Research and Development, Health Services Research and Development, VA Information Resource Center (Project Numbers SDR 02-237 and 98-004).",
year = "2019",
month = jun,
doi = "10.1002/mdc3.12765",
language = "English (US)",
volume = "6",
pages = "369--378",
journal = "Movement Disorders Clinical Practice",
issn = "2330-1619",
publisher = "John Wiley and Sons Ltd",
number = "5",
}