In a study presented at the North American Spine Society Annual Meeting last September, Kevin McGuire, MD, of Lebanon, N.H-based Dartmouth-Hitchcock Medical Center shared findings on hospital costs for spinal fusion patients, according to AAOS Now.
The researchers examined data from 2014 that included 43,425 hospital admissions and identified seven different procedure approaches, with posterior being the most common approach used in around half of the patients.
Five findings on the cost of care:
1. The average hospitalization was $27,182 per patient, with additional costs hitting $25,177 among patients aged 80 years or older. For patients younger than 65 years old, the additional costs reached $27,715.
2. Non-white Medicare beneficiaries incurred higher hospital costs than white beneficiaries, at $28,607 compared to $27,003.
3. The total hospital costs exceeded $40,000 for three of the fusion combination approaches:
• Anterior lumbar interbody fusion or lateral lumbar interbody fusion and posterolateral fusion
• ALIF or LLIF and transforaminal lumbar interbody fusion
• ALIF or LLIF, posterolateral and TLIF
4. The incremental hospital cost estimations where higher for patients 80 years and older, and patients 65 to 69 years old reported the highest average incremental cost increase. Malnutrition added $19,243, malignant tumor present on admission added $14,780 and bone infections on admission increased cost by $13,025.
5. Six comorbid conditions were associated with lower costs, and researchers estimated patients with long-term antiplatelet use lowered the cost by more than $850.
"As alternative payment models continue to evolve, the variability in resource utilization and predicting this variability within a reasonable degree of certainty will allow providers and hospitals to provide upstream resources to decrease complication rates and facilitate care, as well as develop a sustainable economic model for care at the institution," said Kevin J. McGuire, MD, who presented the study at the North American Spine Society Annual Meeting in September 2018.