The Impact of Non-Elective Admission on Cost of Care and Length of Stay in Anterior Cervical Discectomy and Fusion
| Autor: | Alexander J. Schupper, Emily K Chapman, John M. Caridi, Jonathan S. Gal, Michael L Martini, Ian T McNeill, Robert J Rothrock, Sean N Neifert, William H Shuman, Tahera Doctor |
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| Rok vydání: | 2021 |
| Předmět: |
medicine.medical_specialty
Univariate analysis business.industry Anterior cervical discectomy and fusion Retrospective cohort study Length of Stay medicine.disease Comorbidity Confidence interval Postoperative Complications Spinal Fusion Internal medicine Propensity score matching Cohort Cervical Vertebrae medicine Humans Managed care Orthopedics and Sports Medicine Neurology (clinical) business health care economics and organizations Diskectomy Retrospective Studies |
| Zdroj: | Spine. 46:1535-1541 |
| ISSN: | 1528-1159 0362-2436 |
| Popis: | STUDY DESIGN Retrospective cohort study. OBJECTIVE To evaluate the impact of admission status on patient outcomes and healthcare costs in anterior cervical discectomy and fusion (ACDF). SUMMARY OF BACKGROUND DATA Undergoing ACDF non-electively has been associated with higher patient comorbidity burdens. However, the impact of non-elective status on the total cost of hospital stay has yet to be quantified. METHODS Patients undergoing ACDF at a single institution were placed into elective or non-elective cohorts. Propensity score-matching analysis in a 5:1 ratio controlling for insurance type and comorbidities was used to minimize selection bias. Demographics were compared by univariate analysis. Cost of care, length of stay (LOS), and clinical outcomes were compared between groups using multivariable linear and logistic regression with elective patients as reference cohort. All analyses controlled for sex, preoperative diagnosis, elixhauser comorbidity index (ECI), age, length of surgery, number of segments fused, and insurance type. RESULTS Of 708 patients in the final ACDF cohort, 590 underwent an elective procedure and 118 underwent a non-elective procedure. The non-elective group was significantly younger (53.7 vs. 49.5 yr; P = 0.0007). Cohorts had similar proportions of private versus public health insurance, although elective had higher rates of commercial insurance (39.22% vs. 15.25%; P |
| Databáze: | OpenAIRE |
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