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Health care resource utilization decreased each year after lumbar fusion in 2-year longitudinal study
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Although researchers of this longitudinal cohort study noted health care utilization costs decreased each year after lumbar fusion, they found no correlation between the change in Oswestry Disability Index scores and costs at either year following surgery.
Researchers included 66 patients in their analysis. Patients had continuous coverage by a major insurer during the year before decompression and posterolateral instrumented spinal fusion, and the 2.5 years following the procedure. Researchers searched for associations between Oswestry Disability Index (ODI) score improvement at 2 years after surgery and health care resource utilization.
One year after surgery, health care utilization costs decreased by $3,267.59 compared with preoperative costs of $4,246.32. However, researchers noted this difference was not statistically significant.
Compared with preoperative expenditures, investigators found 59% of patients experienced decreased total health care utilization during the first postoperative year and 74% of patients experienced decreased total health care utilization in the second postoperative year.
“Perhaps more important, an anticipated association between patient outcome (ODI improvement at 2 years) and use of health care resources, with the expectation that patients with better outcomes would require fewer postoperative health care resources, was not found. Patients grouped based upon their postop clinical ODI improvement as reaching thresholds of [minimum clinically important difference] MCID or [substantial clinical benefit] SCB demonstrated the same resource utilization. The lack of association between clinical outcome and resource utilization raises the question as to whether there is a rational use of nonsurgical health care resources after lumbar fusion,” researchers wrote in the study. – by Robert Linnehan
Disclosure: The researchers report no relevant financial disclosures.
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