The impact of telesensors on neurosurgical service demand: A cohort cost-effectiveness analysis from institutional and patient perspectives
Fluids and Barriers of the CNS
; 19, 2023.
Article
in English
| EMBASE | ID: covidwho-2238981
ABSTRACT
Introduction:
Implantable telemetric intracranial pressure sensors (telesensors) enable routine, non-invasive ICP feedback which can assist with clinical decision-making and attribution of pressure-related symptoms in patients with CSF shunt systems. Here, we aim to characterise telesensor cost-effectiveness and impact on service demand.Methods:
A single-centre, retrospective, cohort study and costeffectiveness analysis of 80 patients (78% Female;30% IIH, 22% Chiari malformation, 48% other) with MScio® (Christoph Miethke) telemetric ICP monitors. Service demand in the two years before and after implantation were retrieved from the centre's electronic patient record system. Intentionally, data did not overlap with the COVID-19 pandemic period. The frequencies of hydrocephalusrelated neurosurgical admissions, outpatient clinics, and scans were recorded along with A&E, neurology, and ophthalmology encounters. Tariffs were used to compare expenditure before and after implantation.Results:
Significant reductions were seen in the frequencies of neurosurgical admissions (1.9/year to 0.6;p < 0.001), ICP monitoring (0.4 to 0.01;p < 0.001), and CT scans (0.5 to 0.3;p = 0.013) following implantation. There were also significant reductions in the proportion of patients requiring admissions (91% to 45%;p < 0.001) and ICP monitoring (30% to 3%;p < 0.001). There were non-significant reductions in other invasive procedures, neurology encounters, and A&E admissions. Overall, there was a £341 (SD = 1069) per patient per year saving (22% reduction in included costs).Conclusions:
From an institutional perspective, the implantation of telesensors contributes to a reduction in service demand and a net financial saving. From a patient perspective, fewer appointments, invasive procedures, and radiation exposures suggest an improvement in patient experience and safety.
adult; Arnold Chiari malformation; cohort analysis; conference abstract; controlled study; coronavirus disease 2019; cost effectiveness analysis; drug safety; electronic patient record; female; human; implantation; invasive procedure; major clinical study; male; neurology; ophthalmology; outpatient department; pandemic; radiation exposure; retrospective study; surgery; x-ray computed tomography
Full text:
Available
Collection:
Databases of international organizations
Database:
EMBASE
Type of study:
Cohort study
/
Experimental Studies
/
Observational study
/
Prognostic study
Language:
English
Journal:
Fluids and Barriers of the CNS
Year:
2023
Document Type:
Article
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