Evaluation of Cost, Payments, Healthcare Utilization, and Perioperative and Post-Operative Outcomes of Patients Treated with Posterior Lumbar Spinal Surgery Using Open versus Minimally Invasive Surgical Approaches

Chantal E Holy,1,* Katherine A Corso,1,* Dawn E Bowden,2 Michael J Erb,2 Jill R Ruppenkamp,1 Sandra Coombs,3 John B Pracyk3 1Johnson & Johnson Medical Devices Companies, Medical Device Epidemiology and Real World Data Sciences, New Brunswick, NJ, USA; 2Johnson & Johnson Medical Devic...

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Autores principales:	Holy CE, Corso KA, Bowden DE, Erb MJ, Ruppenkamp JR, Coombs S, Pracyk JB
Formato:	article
Lenguaje:	EN
Publicado:	Dove Medical Press 2021
Materias:	minimally invasive surgical procedures database spine lumbar vertebrae propensity score health services research health care costs Medical technology R855-855.5
Acceso en línea:	https://doaj.org/article/f51552dc21204b20bf95d4241c3ff696
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spelling	oai:doaj.org-article:f51552dc21204b20bf95d4241c3ff6962021-12-02T16:04:37ZEvaluation of Cost, Payments, Healthcare Utilization, and Perioperative and Post-Operative Outcomes of Patients Treated with Posterior Lumbar Spinal Surgery Using Open versus Minimally Invasive Surgical Approaches1179-1470https://doaj.org/article/f51552dc21204b20bf95d4241c3ff6962021-06-01T00:00:00Zhttps://www.dovepress.com/evaluation-of-cost-payments-healthcare-utilization-and-perioperative-a-peer-reviewed-fulltext-article-MDERhttps://doaj.org/toc/1179-1470Chantal E Holy,1,* Katherine A Corso,1,* Dawn E Bowden,2 Michael J Erb,2 Jill R Ruppenkamp,1 Sandra Coombs,3 John B Pracyk3 1Johnson & Johnson Medical Devices Companies, Medical Device Epidemiology and Real World Data Sciences, New Brunswick, NJ, USA; 2Johnson & Johnson Medical Devices Companies, Health Economics and Market Access, Raynham, MA, USA; 3DePuy Synthes, Raynham, MA, USA*These authors contributed equally to this workCorrespondence: Katherine A CorsoJohnson & Johnson Medical Devices Companies, Medical Device Epidemiology and Real World Data Sciences, 410 George Street, New Brunswick, NJ, 08901, USATel +1 508 977 6696Email kcorso1@its.jnj.comPurpose: Minimally invasive surgery (MIS) of the spine has been associated with favorable outcomes compared to open surgery. This study evaluated matched cohorts treated with MIS versus open posterior lumbar fusion for costs, payments, healthcare utilization and outcomes.Patients and Methods: This study used the Premier Healthcare and IBM® MarketScan® Commercial and Medicare Databases. Patients with posterior lumbar fusion from 2015 to 2018 were identified and categorized as “Open” or “MIS”. Cohorts were matched on patient and provider characteristics. Perioperative complications, hospital costs, healthcare utilization and post-operative outcomes and payments to providers were analyzed. Statistical significance was evaluated using T-tests and chi-square tests.Results: After matching, 2,388 Open and 796 MIS from PHD, and 415 Open and 83 MIS from MarketScan were included. Statistically significant differences between MIS versus Open were found for index hospital costs, $29,181 (SD: $14,363) versus $27,616 (SD: $13,822), p=0.01; length of stay, 2.94 (SD: 2.10) versus 3.15 (SD: 2.03) days, p=0.01; perioperative urinary tract infection, 1.01% and 2.09% (p=0.05); and 30-day risk of hematoma/hemorrhage, 19.28% versus 8.43%, p=0.02. There were observed, but statistically non-significant differences in additional perioperative or post-operative complications, home discharge, 90-day all-cause and spine-related readmission, and 90-day post-operative payments.Conclusion: Compared to Open, patients that underwent MIS had statistically significant lower length of stay, lower perioperative UTI, greater hospital costs, and higher 30-day risk of hematoma/hemorrhage. The differences observed in post-operative complications and payments and readmissions warrant further investigation in larger matched cohorts.Keywords: minimally invasive surgical procedures, database, spine, lumbar vertebrae, propensity score, health services research, health care costsHoly CECorso KABowden DEErb MJRuppenkamp JRCoombs SPracyk JBDove Medical Pressarticleminimally invasive surgical proceduresdatabasespinelumbar vertebraepropensity scorehealth services researchhealth care costsMedical technologyR855-855.5ENMedical Devices: Evidence and Research, Vol Volume 14, Pp 173-183 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	minimally invasive surgical procedures database spine lumbar vertebrae propensity score health services research health care costs Medical technology R855-855.5
spellingShingle	minimally invasive surgical procedures database spine lumbar vertebrae propensity score health services research health care costs Medical technology R855-855.5 Holy CE Corso KA Bowden DE Erb MJ Ruppenkamp JR Coombs S Pracyk JB Evaluation of Cost, Payments, Healthcare Utilization, and Perioperative and Post-Operative Outcomes of Patients Treated with Posterior Lumbar Spinal Surgery Using Open versus Minimally Invasive Surgical Approaches
description	Chantal E Holy,1,* Katherine A Corso,1,* Dawn E Bowden,2 Michael J Erb,2 Jill R Ruppenkamp,1 Sandra Coombs,3 John B Pracyk3 1Johnson & Johnson Medical Devices Companies, Medical Device Epidemiology and Real World Data Sciences, New Brunswick, NJ, USA; 2Johnson & Johnson Medical Devices Companies, Health Economics and Market Access, Raynham, MA, USA; 3DePuy Synthes, Raynham, MA, USA*These authors contributed equally to this workCorrespondence: Katherine A CorsoJohnson & Johnson Medical Devices Companies, Medical Device Epidemiology and Real World Data Sciences, 410 George Street, New Brunswick, NJ, 08901, USATel +1 508 977 6696Email kcorso1@its.jnj.comPurpose: Minimally invasive surgery (MIS) of the spine has been associated with favorable outcomes compared to open surgery. This study evaluated matched cohorts treated with MIS versus open posterior lumbar fusion for costs, payments, healthcare utilization and outcomes.Patients and Methods: This study used the Premier Healthcare and IBM® MarketScan® Commercial and Medicare Databases. Patients with posterior lumbar fusion from 2015 to 2018 were identified and categorized as “Open” or “MIS”. Cohorts were matched on patient and provider characteristics. Perioperative complications, hospital costs, healthcare utilization and post-operative outcomes and payments to providers were analyzed. Statistical significance was evaluated using T-tests and chi-square tests.Results: After matching, 2,388 Open and 796 MIS from PHD, and 415 Open and 83 MIS from MarketScan were included. Statistically significant differences between MIS versus Open were found for index hospital costs, $29,181 (SD: $14,363) versus $27,616 (SD: $13,822), p=0.01; length of stay, 2.94 (SD: 2.10) versus 3.15 (SD: 2.03) days, p=0.01; perioperative urinary tract infection, 1.01% and 2.09% (p=0.05); and 30-day risk of hematoma/hemorrhage, 19.28% versus 8.43%, p=0.02. There were observed, but statistically non-significant differences in additional perioperative or post-operative complications, home discharge, 90-day all-cause and spine-related readmission, and 90-day post-operative payments.Conclusion: Compared to Open, patients that underwent MIS had statistically significant lower length of stay, lower perioperative UTI, greater hospital costs, and higher 30-day risk of hematoma/hemorrhage. The differences observed in post-operative complications and payments and readmissions warrant further investigation in larger matched cohorts.Keywords: minimally invasive surgical procedures, database, spine, lumbar vertebrae, propensity score, health services research, health care costs
format	article
author	Holy CE Corso KA Bowden DE Erb MJ Ruppenkamp JR Coombs S Pracyk JB
author_facet	Holy CE Corso KA Bowden DE Erb MJ Ruppenkamp JR Coombs S Pracyk JB
author_sort	Holy CE
title	Evaluation of Cost, Payments, Healthcare Utilization, and Perioperative and Post-Operative Outcomes of Patients Treated with Posterior Lumbar Spinal Surgery Using Open versus Minimally Invasive Surgical Approaches
title_short	Evaluation of Cost, Payments, Healthcare Utilization, and Perioperative and Post-Operative Outcomes of Patients Treated with Posterior Lumbar Spinal Surgery Using Open versus Minimally Invasive Surgical Approaches
title_full	Evaluation of Cost, Payments, Healthcare Utilization, and Perioperative and Post-Operative Outcomes of Patients Treated with Posterior Lumbar Spinal Surgery Using Open versus Minimally Invasive Surgical Approaches
title_fullStr	Evaluation of Cost, Payments, Healthcare Utilization, and Perioperative and Post-Operative Outcomes of Patients Treated with Posterior Lumbar Spinal Surgery Using Open versus Minimally Invasive Surgical Approaches
title_full_unstemmed	Evaluation of Cost, Payments, Healthcare Utilization, and Perioperative and Post-Operative Outcomes of Patients Treated with Posterior Lumbar Spinal Surgery Using Open versus Minimally Invasive Surgical Approaches
title_sort	evaluation of cost, payments, healthcare utilization, and perioperative and post-operative outcomes of patients treated with posterior lumbar spinal surgery using open versus minimally invasive surgical approaches
publisher	Dove Medical Press
publishDate	2021
url	https://doaj.org/article/f51552dc21204b20bf95d4241c3ff696
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Evaluation of Cost, Payments, Healthcare Utilization, and Perioperative and Post-Operative Outcomes of Patients Treated with Posterior Lumbar Spinal Surgery Using Open versus Minimally Invasive Surgical Approaches

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