A new study published in Spine attempts to validate claims measurement data as a source to measure lumbar spinal fusion safety.
The study authors compared repeat surgery rates in retrospective analyses of patients undergoing elective spinal procedures based on how the data was obtained. There were 520 patients included in the study who underwent elective spine surgery at a single institution from 1996 to 2011; the patient's medical records for one year after surgery were obtained and the researchers cross-classified each event record with the corresponding value recorded in the claims.
The study authors found:
1. The reoperation rates varied between the chart review and final claims method. For 30 days after surgery, the chart review indicated 1 percent readmission rate while the final claims indicated 0.8 percent; for 90 days after surgery the chart review indicated 1.3 percent readmission rate compared to 1.7 percent for the final claims method.
2. One year after surgery, the chart review indicated 3.6 percent reoperation rate, compared with 3.8 percent in the final claims method.
3. Thirty days after surgery, the claims-based algorithm reported 80 percent sensitivity and 100 percent specificity for repeat surgeries. Ninety days after surgery, the claims-based algorithm reported 100 percent sensitivities and 99.6 percent specificities.
4. One year after surgery, the claims based algorithms reported 94.1 percent sensitivities and 99.2 percent specificities for reoperation. The all-cause readmission sensitivity was 50 percent, according to the report.
5. The study authors found gathering claims based data for patient safety at that institution was "very accurate." "However, the accuracy depended on careful attention to the timing of outcomes, as well as the definitions and coding of repeat surgery, including how orthopedic device removal codes are classified."