The researchers examined multicenter variability in the patient-level resource use for spinal deformity surgery. They calculated outcomes from the Oswestry Disability Index, Scoliosis Research Society-22 and Medical Outcomes Study Short Form-36 questionnaire. Surgeons at different healthcare facilities use implants, biologics and length of stay differently.
There were 250 adult spinal deformity patients who were included in the study, with the average age at 56 years old. The researchers found:
1. There was a significant difference in the average two-year change in the health-related quality of life outcomes across the centers, but after controlling for patients within the same modifier groups, the difference was insignificant.
2. There was a significant difference across the centers in the average resource use per surgery; only the length of stay difference didn’t reach significance.
3. When the researchers controlled for clinical, demographic and regional characteristics at the patient level, the center variation in resource use persisted.
4. The researchers concluded adding surgical resources didn’t impact the two-year health-related quality of life outcomes after adult spinal deformity surgery.
5. Physician preference items had an impact on the surgical resource utilization, highlighting the variation in surgical approach and an opportunity to reduce costs with further standardization.
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