Technology that achieves the Triple Aim: an economic analysis of the BrainPath™ approach in neurosurgery

Figures & data

Table 1 Patient demographics – ICH patients

Demographic	BrainPath	Traditional	p-value
Cases	8	41
Age, years			0.314
17–49	3	11
50–69	2	22
>70	3	8
Gender			0.706
Male	5	21
Female	3	20
Race			0.486
Asian	0	1
Black	2	4
White	6	31
Other/unverified	0	5
Marital status			0.727
Divorced/separated	0	4
Married	4	23
Single	3	10
Widowed	1	4
30-day readmission			0.430
Readmission in 30 days	0	3
No readmission in 30 days	8	38
Status upon discharge			0.663
Alive	7	29
Deceased	1	12

Note: BrainPath™, Nico Corporation, Indianapolis, IN, USA.

Abbreviation: ICH, intracerebral hemorrhage.

Table 2 ICU days reduction in ICH patients

	MS-DRG 23–24		p-value
	Traditional	BrainPath™
Number of patients	41	14
Average ICU days	11.9	4.4	0.01
Reduction in ICU days		105.0
Variable direct cost savings ($2,007/day)^*		$210,735
Estimated savings ($3,088/day)a		$324,208

Notes:

a Cost savings is estimated in United States dollars ($) based on the variable direct cost of a day in the neurological critical care calculated as $2,007 per day. A value of $3,088 was assumed for the full cost, including fixed overhead and allocations, of an ICU patient day.³ BrainPath™, Nico Corporation, Indianapolis, IN, USA.

Abbreviations: ICU, intensive care unit; ICH, intracerebral hemorrhage; MS-DRG, Medicare Severity - Diagnosis Related Group.

Table 3 Patient demographics – brain tumor patients

Demographic	BrainPath™	Traditional	p-value
Cases	10	167
Age, years			0.646
17–49	6	88
50–69	4	66
>70 years	0	13
Gender			0.319
Male	8	99
Female	2	68
Race			>0.001
Asian	0	1
Black	0	5
White	10	156
Other/unverified	0	6
Marital status			0.462
Divorced/separated	0	18
Married	8	96
Single	2	44
Widowed	0	9
30-day readmission			0.247
Readmission in 30 days	2	15
No readmission in 30 days	8	152
Status upon discharge			0.100
Alive	7	149
Deceased	3	18

Note: BrainPath™, Nico Corporation, Indianapolis, IN, USA.

Table 4 ICU days reduction in brain tumor patients

	MS-DRG 25–27
	Traditional	BrainPath	p-value
Number of patients	167	14
Average ICU days	1.8	1.0	0.07
Reduction in ICU days		11.2
Variable direct cost savings ($2,007/day)a		$22,478

Notes:

a Cost savings is estimated in United States dollars ($) based on the variable direct cost of a day in the neurological critical care calculated as $2,007 per day. A value of $3,088 was assumed for the full cost, including fixed overhead and allocations, of an ICU patient day.³ BrainPath™, Nico Corporation, Indianapolis, IN, USA.

Abbreviations: ICU, intensive care unit; MS-DRG, Medicare Severity - Diagnosis Related Group.

Table 5 Net estimated economic benefit with BrainPath™

ICU days at full cost for ICH cases	$324,208
Marginal reimbursement from 14 ICH surgical cases	$113,250
ICU days at variable direct cost for brain tumor cases	$22,478
Marginal reimbursement from two tumor surgical cases	$19,523
BrainPath disposable cost for 28 cases	$(112,000)
Depreciation expense ×28 months	$(37,800)
Net estimated economic benefit of BrainPath technology^a	$329,659

Notes: Calculations in US dollars. Based on the variable direct cost of a day in the neurological critical care unit calculated as $2,007 per day and the full cost as $3,088 per day. A monthly depreciation expense of $1,350 over 28 months was assumed. BrainPath demonstrated a net financial value to the investigator’s academic institution of $329,659. BrainPath™, Nico Corporation, Indianapolis, IN, USA.

Abbreviations: ICU, intensive care unit; ICH, intracerebral hemorrhage.

US Food and Drug Administration [homepage on the Internet]FDA 510k Clearance for BrainPath Available from: http://www.accessdata.fda.gov/scripts/cdrh/cfdocs/cfpmn/pmn_template.cfm?id=k150378Accessed June 5, 2017

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