Healthcare utilization and 30-day in-hospital costs following brain tumor surgery: A single-center, retrospective cohort study

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Abstract Background Brain tumors cause more than 248 000 deaths annually, and their incidence continues to rise. Despite medical advances, outcomes have improved marginally, and the associated economic burden is substantial. European spending was estimated at €37.8 billion in 2019. Although several cost drivers have been identified, robust and methodologically sound cost evaluations remain limited. This study aimed to quantify 30-day in-hospital healthcare consumption and identify cost drivers in brain tumor surgery. Methods Adult patients undergoing brain tumor surgery in 2023 at a single regional referral center were retrospectively analyzed. The primary outcome was total 30-day in-hospital costs, calculated using a bottom-up microcosting approach. Univariable and multivariable analyses were performed to identify key cost drivers. Results A total of 322 patients (mean age 61 years; 51.2% female) were included in this study. Median length of stay (LOS) was 3 days (interquartile range; 2-6), and mean in-hospital costs were € 6988 per patient (SD ± € 4273). Tumor pathology was associated with significantly increased surgical costs (P = .035) but did not significantly influence overall costs (P = .376). Multivariable analysis identified surgery type, preoperative Karnofsky Performance Status, total LOS, intensive care unit LOS, and Clavien-Dindo complication grade as independent cost drivers. Repeat surgery, readmission, and 30-day mortality further increased costs. Conclusions Thirty-day in-hospital costs following brain tumor surgery are substantial, mainly driven by operative and hospitalization factors. Identifying modifiable cost determinants is essential for developing targeted interventions to improve efficiency and optimize resource utilization.

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