Determinants and Variations of Hospital Costs in Patients With Lumbar Radiculopathy Hospitalized for Spinal Surgery. Issue 5 (1st March 2019)

• Record Type: Journal Article
• Authors: Huysmans, Eva; Pien, Karen; Callens, Lieselot; Van Loon, Lesley; Ickmans, Kelly; Nijs, Jo; Buyl, Ronald; Moens, Maarten; Goudman, Lisa; Van Belleghem, Griet; Putman, Koen
• Is Part Of: Spine. Volume 44:Issue 5(2019)
• Publication Date: 2019-03-01
• Subjects: care trajectory -- determinants -- hospital costs -- intramural costs -- leg pain -- low back -- lumbar surgery -- neurosurgery -- orthopedic surgery -- radiculopathy; Spine -- Abnormalities -- Periodicals; Spine -- Diseases -- Periodicals; Spine -- Surgery -- Periodicals; 616.73005
• DOI: 10.1097/BRS.0000000000002801
• Languages: English
• ISSNs: 0362-2436

Abstract

Abstract : Study Design: A retrospective study. Objective: The aim of this study was to determine hospital costs related to surgery for lumbar radiculopathy and identify determinants of intramural costs based on minimal hospital and claims data. Summary of Background Data: Costs related to the initial hospitalization of patients undergoing surgery for lumbar radiculopathy make up the major part of direct health care expenditure in this population. Identifying factors influencing intramural costs can be beneficial for health care policy makers, and clinicians working with patients with lumbar radiculopathy. Methods: The following data were collected from the University Hospital Brussels data warehouse for all patients undergoing surgery for lumbar radiculopathy in 2016 (n = 141): age, sex, primary diagnosis, secondary diagnoses, type of surgery, severity of illness (SOI), admission and discharge date, type of hospital admission, and all claims incurred for the particular hospital stay. Descriptive statistics for total hospital costs were performed. Univariate analyses were executed to explore associations between hospital costs and all other variables. Those showing a significant association ( P < 0.05) were included in the multivariate general linear model analysis. Results: Mean total hospital costs were [Euro sign] 5016 ± 188 per patient. Costs related to the actual residence ( i.e ., "hotel costs") comprised 53% of the total hospital costs, whereas 18% of the costs were claimed for the surgical procedure. Patients with moderate/major SOI had 44% higher hospital costs than minor SOI ( P = 0.01). Presence of preadmission comorbidities incurred 46% higher costs ( P = 0.03). Emergency procedures led to 72% higher costs than elective surgery ( P < 0.001). Patients receiving spinal fusion had 211% higher hospital costs than patients not receiving this intervention ( P < 0.001). Conclusion: Hospital costs in patients receiving surgery for lumbar radiculopathy are influenced by SOI, the presence of preadmission comorbidities, type of hospital admission (emergency vs. elective), and type of surgical procedure. Level of Evidence: 3 Abstract : The objective of this study was to determine hospital costs related to surgery for lumbar radiculopathy and to identify determinants of intramural costs. Mean total hospital costs were [Euro sign] 5000. Hospital costs were influenced by severity of illness, preadmission comorbidities, type of hospital admission, and type of surgical procedure.