Resources utilisation and economic burden of percutaneous vertebroplasty or percutaneous kyphoplasty for treatment of osteoporotic vertebral compression fractures in China: a retrospective claim database study

Abstract Background: Osteoporotic vertebral compression fractures (OVCF) is a common and often debilitating complication of osteoporosis, leading to significant morbidity and increased mortality. Percutaneous vertebroplasty (PVP) and Percutaneous kyphoplasty (PKP) are recommendable surgical treatments for OVCF. Objective: To evaluate PVP/PKP utilisation and their related direct medical costs for OVCF treatment in China from the payer perspective. Methods: A population-based medical claims database of a metropolitan city in China was analysed from the payer perspective, which included all inpatient claims from 01/01/2015 to 31/12/2017. All vertebral fractures patients that met the eligibility criteria (aged ≥50 years old, having vertebral fracture diagnosis, without unrelated diseases diagnoses such as tumour and scoliosis, received PVP/PKP) were deemed as OVCF patients. Baseline characteristics, surgery rate, length of stay in hospital, time to re-surgery, and costs (including costs per hospitalisation and annual costs) were described. Survival analysis function was used to estimate and re-surgery rate. Results: Of the 50,686 patients with OVCF identified, 14,527 (28.66%) received a total number of 15,599 records of PVP/PKP surgeries from 2015 to 2017. Mean age was 75 at the first surgery captured in the database analysis period; females accounted for 79.54% of all cases. The median length of surgery stay was 9 days. Cumulative re-surgery rates were 1.22% in 30 days, 2.58% in 90 days, 3.61% in 183 days, 5.42% in one year, and 7.95% in two years. There was no significant difference in re-surgery rate between PVP and PKP (p=0.3897). The median time to the re-surgery was 139 days. Mean costs per PVP/PKP-related hospitalisation were 35,906 CNY/5,122 USD (34,195 CNY/4,878USD for PVP, 44,414 CNY/6,336 USD for PKP, p<0.01). The overall costs of hospitalisation averaged 186.61 million CNY (26.62 million USD) per year in this metropolitan city. Conclusion: From 2015 to 2017, nearly one-third of OVCF inpatients received PVP/PKP and the re-surgery rate was 7.95%. PVP/PKP procedures for OVCF place a high economic burden for both the healthcare system and patients. Early detection and treatment of patients with osteoporosis are critical in China. Keywords: OVCF; percutaneous vertebroplasty; percutaneous kyphoplasty; surgery; costs

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Utilization and economic burden of Percutaneous Vertebroplasty or Percutaneous Kyphoplasty for Treatment of Osteoporotic Vertebral Compression Fractures in China: A Retrospective Claim Database Study

10.21203/rs.2.14665/v1 ◽

2019 ◽

Author(s):

Dehong Yang ◽

Yanlei Zhang ◽

Xiao Ma ◽

Li Huo ◽

Liran Li ◽

...

Keyword(s):

Economic Burden ◽

Percutaneous Vertebroplasty ◽

Statistical Tests ◽

Population Based ◽

Vertebral Compression Fractures ◽

Claim Database ◽

Osteoporotic Vertebral Compression Fractures ◽

Compression Fractures ◽

Percutaneous Kyphoplasty ◽

Significant Difference

Abstract Background Osteoporotic vertebral compression fractures (OVCF) is a common and often debilitating complication of osteoporosis, leading to significant morbidity and increased mortality. Percutaneous vertebroplasty (PVP) and Percutaneous kyphoplasty (PKP) are recommendable surgical treatments for osteoporotic vertebral compression fractures.Objective To evaluate PVP/PKP utilization and their related costs for OVCF treatment in China.Methods A population-based medical claims database of a metropolitan city in China was analyzed, which included all inpatient claims from 01/01/2015 to 31/12/2017. Eligible patients were 50 years or older, diagnosed with vertebral fractures with/without osteoporosis, and received PVP/PKP. Survival analysis function was used to estimate time to re-surgery and non-parametric statistical tests were used for comparison of cost and re-surgery rate between PVP and PKP.Results Of the 50,686 patients with OVCF identified, 14,527 (28.66%) received a total number of 15,599 records of PVP/PKP surgeries from 2015 to 2017. Mean age was 75 at the first surgery captured in the database analysis period; and females accounted for 79.54% of all cases. Median length of surgery stay was 9 days. Cumulative re-surgery rates were 1.22% in 30 days, 2.58% in 90 days, 3.61% in 183 days, 5.42% in one year, and 7.95% in two years. There was no significant difference of re-surgery rate between PVP and PKP (p=0.3897). Median time to the re-surgery was 139 days. Mean cost per PVP/PKP-related hospitalization was 35,906 CNY (34,195 CNY for PVP, 44,414 CNY for PKP, p<0.01). The overall cost of hospitalization averaged 186.61 million CNY (26.97 million USD) per year in this metropolitan city.Conclusion From 2015 to 2017, nearly one third of OVCF inpatients received PVP/PKP and re-surgery rate was high. PKP/PVP procedures for OVCF place a high economic burden for both the healthcare system and patients. Early detection and treatment of patients with osteoporosis is critical in China.

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Resources Utilisation and Economic Burden of Percutaneous Vertebroplasty or Percutaneous Kyphoplasty for Treatment of Osteoporotic Vertebral Compression Fractures in China: A Retrospective Claim Database Study

10.21203/rs.2.14665/v3 ◽

2020 ◽

Author(s):

Dehong Yang ◽

Yanlei Zhang ◽

Xiao Ma ◽

Li Huo ◽

Liran Li ◽

...

Keyword(s):

Economic Burden ◽

Percutaneous Vertebroplasty ◽

Vertebral Compression Fractures ◽

Claim Database ◽

Osteoporotic Vertebral Compression Fractures ◽

Compression Fractures ◽

Percutaneous Kyphoplasty ◽

Metropolitan City ◽

Payer Perspective ◽

Significant Difference

Abstract Background: Osteoporotic vertebral compression fractures (OVCF) is a common and often debilitating complication of osteoporosis, leading to significant morbidity and increased mortality. Percutaneous vertebroplasty (PVP) and Percutaneous kyphoplasty (PKP) are recommendable surgical treatments for OVCF. Objective: To evaluate PVP/PKP utilisation and their related direct medical costs for OVCF treatment in China from the payer perspective. Methods: A population-based medical claims database of a metropolitan city in China was analysed from the payer perspective, which included all inpatient claims from 01/01/2015 to 31/12/2017. All vertebral fractures patients that met the eligibility criteria (aged ≥50 years old, having vertebral fracture diagnosis, without unrelated diseases diagnoses such as tumour and scoliosis, received PVP/PKP) were deemed as OVCF patients. Baseline characteristics, surgery rate, length of stay in hospital, time to re-surgery, and costs (including costs per hospitalisation and annual costs) were described. Survival analysis function was used to estimate and re-surgery rate. Results: Of the 50,686 patients with OVCF identified, 14,527 (28.66%) received a total number of 15,599 records of PVP/PKP surgeries from 2015 to 2017. Mean age was 75 at the first surgery captured in the database analysis period; females accounted for 79.54% of all cases. The median length of surgery stay was 9 days. Cumulative re-surgery rates were 1.22% in 30 days, 2.58% in 90 days, 3.61% in 183 days, 5.42% in one year, and 7.95% in two years. There was no significant difference in re-surgery rate between PVP and PKP (p=0.3897). The median time to the re-surgery was 139 days. Mean costs per PVP/PKP-related hospitalisation were 35,906 CNY/5,122 USD (34,195 CNY/4,878USD for PVP, 44,414 CNY/6,336 USD for PKP, p<0.01). The overall costs of hospitalisation averaged 186.61 million CNY (26.62 million USD) per year in this metropolitan city. Conclusion: From 2015 to 2017, nearly one-third of OVCF inpatients received PVP/PKP and the re-surgery rate was 7.95%. PVP/PKP procedures for OVCF place a high economic burden for both the healthcare system and patients. Early detection and treatment of patients with osteoporosis are critical in China.

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PSU43 A REAL-WORLD SURGERY STATUS, RESOURCE USE AND COSTS OF PATIENTS RECEIVING PERCUTANEOUS VERTEBROPLASTY (PVP) OR PERCUTANEOUS KYPHOPLASTY (PKP) DUE TO OSTEOPOROTIC VERTEBRAL COMPRESSION FRACTURES (OVCF) IN CHINA

Value in Health ◽

10.1016/j.jval.2019.04.1821 ◽

2019 ◽

Vol 22 ◽

pp. S372

Author(s):

D.H. Yang ◽

Y.L. Zhang ◽

L. Huo ◽

X. Ma ◽

L. Li ◽

...

Keyword(s):

Resource Use ◽

Real World ◽

Percutaneous Vertebroplasty ◽

Vertebral Compression Fractures ◽

Osteoporotic Vertebral Compression Fractures ◽

Compression Fractures ◽

Percutaneous Kyphoplasty

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Comparison between percutaneous vertebroplasty and percutaneous kyphoplasty in the treatment of posterior wall rupture and osteoporotic vertebral compression fractures-Case - based retrospective study

10.21203/rs.3.rs-19906/v1 ◽

2020 ◽

Author(s):

Yong-sheng Gou ◽

Yue Hu ◽

Hai-bo Li ◽

Bo-lin fu ◽

Zheng Che

Keyword(s):

Retrospective Study ◽

Clinical Efficacy ◽

Percutaneous Vertebroplasty ◽

Compression Fracture ◽

Operation Time ◽

Posterior Wall ◽

Vertebral Compression Fractures ◽

Osteoporotic Vertebral Compression Fractures ◽

Compression Fractures ◽

Percutaneous Kyphoplasty

Abstract Background: Percutaneous kyphoplasty (PKP) or percutaneous vertebral plasty (PVP) has been widely applied in the treatment of osteoporotic vertebral compression fractures (osteoporotic vertebral compression will fracture, OVCF) because of its minimally invasive and effective. To compare the clinical efficacy and safety of percutaneous vertebroplasty versus percutaneous kyphoplasty for osteoporotic vertebral compression fractures with posterior wall broken. Methods: 82 patients with osteoporotic vertebral compression fracture with posterior wall broken were divided into PVP group(group A) and PKP group(group B)．The operation time, perspective times, bone cement volume injected. cement leakage, hospitalization expenses, preoperative visual analog score(VAS) and Oswestry disability index(ODI), restoration height of vertebral, the vertebrae height loss and new fracture of adjacent vertebra were evaluated during the follow-up. Results: The PVP group incurred significantly shorter operation time(40.37 ±8.26 min) and less perspective times (22.23 ±3.79 times)than the PKP group(46.74 ±9.58 min and 27.96 ±5.71 times respectively)( P<0.05). The PVP group incurred significantly less expenses than the PKP group(P<0.05). The VAS scores and ODI at 1 day and 6 months post-operation were significantly lower than pre-operation in both groups(P<0.05). Conclusion: Both PVP and PKP Can obtain satisfactory clinical efficacy for the treatment of osteoporotic vertebral compression fractures with posterior wall broken,but the former may have advantages of less expenses,shorter operation time. Trial registration: This retrospective study was approved by the ethics committee of the first people's hospital of shuangliu district, Chengdu, Moreover, this study was also registered in the Chinese clinical trial registry with the registration number of ChiCTR1900028176.

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