Socioeconomic Trends in Deep Brain Stimulation (DBS) Surgery.

ABSTRACT

OBJECTIVE: We evaluated trends in deep brain stimulation (DBS) for the 14-year period from 1993 to 2006. MATERIALS AND METHODS: We utilized the Nationwide Inpatient Sample data base from the Healthcare Cost and Utilization Project, Agency for Healthcare Research and Quality. RESULTS: A total of 34,792 patients underwent DBS surgery from 1993 to 2006. There were 756 DBS cases performed in 1993 compared with 4200 DBS procedures performed in 2006. Significant increases in nationwide DBS volume coincided with regulatory approval for new indications-Parkinson's disease and dystonia, respectively. Cost of DBS surgery increased from $38,840 in 1993 to $69,329 in 2006. The majority of cases were done in metropolitan areas (97%) at large academic centers (91%) at a national bill of $291 MM. CONCLUSIONS: Future studies will need to include the socioeconomic impact of the technology on disease status, patient access, and costs as it expands to novel indications.