Predictive Analysis of Healthcare Resource Utilization after Elective Spine Surgery
Introduction: The management of degenerative spine pathology continues to be a significant source of costs to the US healthcare system. Besides surgery, utilization of healthcare resources after spine surgery drives costs. The responsibility of managing costs is gradually shifting to patients and pr...
| Main Authors: | , , , , , , , , , |
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| Format: | Article |
| Language: | English |
| Published: |
The Japanese Society for Spine Surgery and Related Research
2022-11-01
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| Series: | Spine Surgery and Related Research |
| Subjects: | |
| Online Access: | https://www.jstage.jst.go.jp/article/ssrr/6/6/6_2022-0030/_pdf/-char/en |
| _version_ | 1811200986700578816 |
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| author | Erik B. Gerlach Felipe Ituarte Mark A. Plantz Peter R. Swiatek Nicholas A. Arpey Jeremy S. Marx David J. Fei-Zhang Srikanth N. Divi Wellington K. Hsu Alpesh A. Patel |
| author_facet | Erik B. Gerlach Felipe Ituarte Mark A. Plantz Peter R. Swiatek Nicholas A. Arpey Jeremy S. Marx David J. Fei-Zhang Srikanth N. Divi Wellington K. Hsu Alpesh A. Patel |
| author_sort | Erik B. Gerlach |
| collection | DOAJ |
| description | Introduction: The management of degenerative spine pathology continues to be a significant source of costs to the US healthcare system. Besides surgery, utilization of healthcare resources after spine surgery drives costs. The responsibility of managing costs is gradually shifting to patients and providers. Patient-centered predictors of healthcare utilization after elective spine surgery may identify targets for cost reduction and value creation. Therefore, our study aims to quantify patterns of healthcare utilization and identify risk factors that predict high healthcare utilization after elective spine surgery.
Methods: A total of 623 patients who underwent elective spine surgery at a tertiary academic medical center by one of three fellowship-trained orthopedic spine surgeons between 2013 and 2018 were identified in this retrospective cohort study. Healthcare utilization was quantified including advanced spine imaging, emergency and urgent care visits, hospital readmission, reoperation, PT/OT referrals, opioid prescriptions, epidural steroid injections, and pain management referrals. Patient variables, namely, the Charlson comorbidity index (CCI) and the American Society of Anesthesiologists (ASA) classification system, were assessed as potential predictors for healthcare utilization.
Results: Among all patients, a wide range of health utilization was identified. Age, body mass index, Charlson Comorbidity Index, and American Society of Anesthesiology class were identified as positive predictors of postoperative healthcare utilization including emergency department visits, spine imaging studies, opioid and nerve blocker prescriptions, inpatient rehabilitation, any referrals, and pain management referrals.
Conclusions: Markers of patient health―such as CCI and ASA class―may be used to predict healthcare utilization following elective spine surgery. Identifying at-risk patients and addressing these challenges prior to surgery is an important step to deliver efficient postoperative care.
Level of Evidence: 3 |
| first_indexed | 2024-04-12T02:13:34Z |
| format | Article |
| id | doaj.art-a07cb6f7a5a24acc96b1d780eaad7693 |
| institution | Directory Open Access Journal |
| issn | 2432-261X |
| language | English |
| last_indexed | 2024-04-12T02:13:34Z |
| publishDate | 2022-11-01 |
| publisher | The Japanese Society for Spine Surgery and Related Research |
| record_format | Article |
| series | Spine Surgery and Related Research |
| spelling | doaj.art-a07cb6f7a5a24acc96b1d780eaad76932022-12-22T03:52:19ZengThe Japanese Society for Spine Surgery and Related ResearchSpine Surgery and Related Research2432-261X2022-11-016663864410.22603/ssrr.2022-00302022-0030Predictive Analysis of Healthcare Resource Utilization after Elective Spine SurgeryErik B. Gerlach0Felipe Ituarte1Mark A. Plantz2Peter R. Swiatek3Nicholas A. Arpey4Jeremy S. Marx5David J. Fei-Zhang6Srikanth N. Divi7Wellington K. Hsu8Alpesh A. Patel9Department of Orthopaedic Surgery, Northwestern Feinberg School of MedicineDepartment of Orthopaedic Surgery, Northwestern Feinberg School of MedicineDepartment of Orthopaedic Surgery, Northwestern Feinberg School of MedicineDepartment of Orthopaedic Surgery, Northwestern Feinberg School of MedicineDepartment of Orthopaedic Surgery, Northwestern Feinberg School of MedicineDepartment of Orthopaedic Surgery, Northwestern Feinberg School of MedicineDepartment of Orthopaedic Surgery, Northwestern Feinberg School of MedicineDepartment of Orthopaedic Surgery, Northwestern Feinberg School of MedicineDepartment of Orthopaedic Surgery, Northwestern Feinberg School of MedicineDepartment of Orthopaedic Surgery, Northwestern Feinberg School of MedicineIntroduction: The management of degenerative spine pathology continues to be a significant source of costs to the US healthcare system. Besides surgery, utilization of healthcare resources after spine surgery drives costs. The responsibility of managing costs is gradually shifting to patients and providers. Patient-centered predictors of healthcare utilization after elective spine surgery may identify targets for cost reduction and value creation. Therefore, our study aims to quantify patterns of healthcare utilization and identify risk factors that predict high healthcare utilization after elective spine surgery. Methods: A total of 623 patients who underwent elective spine surgery at a tertiary academic medical center by one of three fellowship-trained orthopedic spine surgeons between 2013 and 2018 were identified in this retrospective cohort study. Healthcare utilization was quantified including advanced spine imaging, emergency and urgent care visits, hospital readmission, reoperation, PT/OT referrals, opioid prescriptions, epidural steroid injections, and pain management referrals. Patient variables, namely, the Charlson comorbidity index (CCI) and the American Society of Anesthesiologists (ASA) classification system, were assessed as potential predictors for healthcare utilization. Results: Among all patients, a wide range of health utilization was identified. Age, body mass index, Charlson Comorbidity Index, and American Society of Anesthesiology class were identified as positive predictors of postoperative healthcare utilization including emergency department visits, spine imaging studies, opioid and nerve blocker prescriptions, inpatient rehabilitation, any referrals, and pain management referrals. Conclusions: Markers of patient health―such as CCI and ASA class―may be used to predict healthcare utilization following elective spine surgery. Identifying at-risk patients and addressing these challenges prior to surgery is an important step to deliver efficient postoperative care. Level of Evidence: 3https://www.jstage.jst.go.jp/article/ssrr/6/6/6_2022-0030/_pdf/-char/enspine surgerycostutilizationqualityeconomic |
| spellingShingle | Erik B. Gerlach Felipe Ituarte Mark A. Plantz Peter R. Swiatek Nicholas A. Arpey Jeremy S. Marx David J. Fei-Zhang Srikanth N. Divi Wellington K. Hsu Alpesh A. Patel Predictive Analysis of Healthcare Resource Utilization after Elective Spine Surgery Spine Surgery and Related Research spine surgery cost utilization quality economic |
| title | Predictive Analysis of Healthcare Resource Utilization after Elective Spine Surgery |
| title_full | Predictive Analysis of Healthcare Resource Utilization after Elective Spine Surgery |
| title_fullStr | Predictive Analysis of Healthcare Resource Utilization after Elective Spine Surgery |
| title_full_unstemmed | Predictive Analysis of Healthcare Resource Utilization after Elective Spine Surgery |
| title_short | Predictive Analysis of Healthcare Resource Utilization after Elective Spine Surgery |
| title_sort | predictive analysis of healthcare resource utilization after elective spine surgery |
| topic | spine surgery cost utilization quality economic |
| url | https://www.jstage.jst.go.jp/article/ssrr/6/6/6_2022-0030/_pdf/-char/en |
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