Multiyear Stroke Study Shows Significant Improvements in Cost Savings and Patient Outcomes Realized by Utilizing Premium Area Detector CT Technology

In five years, Kaleida Health’s Stroke Care Center (SCC) at the Gates Vascular Institute in Buffalo, N.Y., realized more than $5.4 million in cost savings by using the AquilionTM ONE CT system from Toshiba Medical, a Canon Group company, to diagnose acute stroke. A multiyear study showed dramatic improvements in patient outcomes across a variety of resource-intensive ICD-9-CM codes, with an up-to-a-full-day reduction in patient length of stay and better discharge dispositions. These results demonstrate that with the right multidisciplinary approach and advanced imaging technology, providers can contain costs while delivering high-quality, effective care that meets the demands of the modern healthcare environment.

five years, Kaleida Health’s Stroke Care Center (SCC) at the Gates Vascular Institute in Buffalo, N.Y., realized more than $5.4 million in cost savings by using the AquilionTM ONE CT system from Toshiba Medical, a Canon Group company, to diagnose acute stroke. A multiyear study showed dramatic improvements in patient outcomes across a variety of resource-intensive ICD-9-CM codes, with an up-to-a-full-day reduction in patient length of stay and better discharge dispositions. These results demonstrate that with the right multidisciplinary approach and advanced imaging technology, providers can contain costs while delivering high-quality, effective care that meets the demands of the modern healthcare environment.

Highlights of the findings include (full data set on file):

Length-of-Stay Data

ICD-9-CM Code 2007 Inpatient Cases – Average Days Length of Stay (w/o Aquilion ONE) 2009 Inpatient Cases – Average Days Length of Stay (w/ Aquilion ONE) 2010 Inpatient Cases – Average Days Length of Stay (w/ Aquilion ONE) 2011 Inpatient Cases – Average Days Length of Stay (w/ Aquilion ONE) 2012 Inpatient Cases – Average Days Length of Stay (w/ Aquilion ONE)
434.91 – Unspecified Cerebral Artery Occlusion with Cerebral Infarction 6.03 5.58 5.24

5.23

4.98

435.9 – Unspecified Transient Cerebral Ischemia 2.69 2.55 2.51

2.7*

2.9*

434.11 – Cerebral Embolism with Cerebral Infarction 7.3 7.16 6.93

6.57

5.56

Chart Caption: In 2011 and 2012, the SCC saw an even greater reduction in patient length of stay, demonstrating quicker recovery times and ultimately lower healthcare costs.

*Length of stay for ICD-9-CM code 435.9 (Unspecified Transient Cerebral Ischemia) appeared to increase between 2007 and 2011, and between 2007 and 2012. This is in part attributable to correctly identified Unspecified Transient Cerebral Ischemia cases being admitted to the hospital; other, Non-Unspecified Transient Cerebral Ischemia cases would have been discharged as outpatient, thereby increasing the weight of the length of stay for the true Unspecified Transient Cerebral Ischemia cases.

Change in Discharge Disposition

ICD-9-CM Code Change in Discharge Disposition from 2007 to 2009 Change in Discharge Disposition from 2007 to 2010 Change in Discharge Disposition from 2007 to 2011 Change in Discharge Disposition from 2007 to 2012
434.91 – Unspecified Cerebral Artery Occlusion with Cerebral Infarction 19.5% increase in patients discharging home 14.8% increase in patients discharging home 55.3% increase in patients discharging home 65.3% increase in patients discharging home
435.9 – Unspecified Transient Cerebral Ischemia** 76.4% increase in patients discharging to home healthcare 23.3% increase in patients discharging to home healthcare 7.1% increase in patients discharging home 6.9% increase in patients discharging home
434.11 – Cerebral Embolism with Cerebral Infarction 62.8% increase in patients discharging home 20% improvement in patients discharging to home 73.3% increase in patients discharging home 67% increase in patients discharging home

Chart Caption: The discharge disposition for patients at the SCC continued to improve in 2011 and 2012 with further use of the Aquilion ONE. For example, patients falling under ICD-9-CM 434.11, the most resource-intensive code, saw a more than 73 percent increase in patients discharged to home in the 2011 data, and a further 67 percent increase in home discharge in the 2012 data.

**2009–2010 data for ICD-9-CM code 435.9 reflects the increase in patients discharging to home healthcare. 2011 saw the first increase in discharge to home for ICD-9-CM code 435.9, thanks in part to the improved patient care facilitated by the Aquilion ONE.

Healthcare Cost Savings

ICD-9-CM Code 2009 Quarterly Total Cost Savings 2010 Quarterly Total Cost Savings 2011 Quarterly Total Cost Savings 2012 Quarterly Total Cost Savings
434.91 – Unspecified Cerebral Artery Occlusion with Cerebral Infarction $118,367 $197,962

$180,567

$236,910

435.9 – Unspecified Transient Cerebral Ischemia $42,742 $43,856

$44,600

$57,732

434.11 – Cerebral Embolism with Cerebral Infarction $29,400 $86,672

$99,918

$212,172

Annualized Savings Total $762,036 $1,313,960 $1,300,340 $2,027,256

Chart Caption: In total, over the past four years, the SCC has achieved more than $5.4 million in annualized savings by using the Aquilion ONE to diagnose stroke.

“Our long-standing partnership with the SCC at the Gates Vascular Institute demonstrates that with advanced imaging technology and the right multidisciplinary approach, providers can significantly improve patient outcomes and reduce overall healthcare costs,” said Tom Szostak, director, Healthcare Economics, Toshiba America Medical Systems, Inc. “Toshiba Medical is proud to be a collaborative partner in helping our customers meet their business needs and the needs of their unique patient populations. Together, we can deliver high-quality care to more patients.”

Pauline T. Mayer is editor of Medical Device News Magazine, which is a division of PTM Healthcare Marketing, Inc.

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