2018
DOI: 10.3171/2017.7.spine1714
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Bundled payment reimbursement for anterior and posterior approaches for cervical spondylotic myelopathy: an analysis of private payer and Medicare databases

Abstract: OBJECTIVECervical spondylotic myelopathy (CSM) is a progressive spinal condition that often requires surgery. Studies have shown the clinical equivalency of anterior versus posterior approaches for CSM surgery. The purpose of this study was to determine the amount and type of resources used for anterior and posterior surgical treatment of CSM by using large national databases of clinical and financial information from patients. Show more

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Cited by 26 publications
(17 citation statements)
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“…23,24,28 Reducing 90-day hospital readmission rates improves patient quality of life, decreases the total cost during the postoperative global period, and avoids penalization from the Medicare Hospital Readmission Reduction Program. 7,9,23,29 In this cohort, ASA score, cervical myelopathy as the indication for surgery, and increased length of surgery were significantly associated with 90-day readmission rates. ASA score had the greatest association for requiring a readmission, and length of surgery although statistically significant had a negligible OR of 1.002.…”
Section: Discussionmentioning
confidence: 75%
See 1 more Smart Citation
“…23,24,28 Reducing 90-day hospital readmission rates improves patient quality of life, decreases the total cost during the postoperative global period, and avoids penalization from the Medicare Hospital Readmission Reduction Program. 7,9,23,29 In this cohort, ASA score, cervical myelopathy as the indication for surgery, and increased length of surgery were significantly associated with 90-day readmission rates. ASA score had the greatest association for requiring a readmission, and length of surgery although statistically significant had a negligible OR of 1.002.…”
Section: Discussionmentioning
confidence: 75%
“…[1][2][3][4][5] The total cost of ACDF surgery varies, and spine surgeons are under more pressure to minimize the cost of surgery. [6][7][8][9] In a study investigating variability in the cost of ACDF surgery, the cost of surgery ranged from $26 653 to $129 220. 10 Bundled repayment provides a fixed fee for service for the surgical hospitalization and for the 90-day postoperative period.…”
Section: Introductionmentioning
confidence: 99%
“…We also performed a multivariable analysis for each outcome using linear regression on log-transformed values for continuous outcomes and logistic regression for categorical outcomes. In these models, we included all patient characteristics (gender, age, Elixhauser index and insurance type [19]) in addition to the fusion approach. From these models, we built a linear contrast to compare different groups to the reference group.…”
Section: Methodsmentioning
confidence: 99%
“…38 The main purpose of surgery is usually to decompress the spinal cord while stabilizing the affected segments, and sometimes to prevent or cease progression of kyphotic deformity in the future. 1,15,64 Spinal cord decompression can be performed via anterior, posterior, or combined approaches, which has been a classic topic of debate in spine surgery. Anterior surgery has included discectomy and corpectomy with or without instrumentation, whereas posterior options have included laminoplasty and laminectomy with or without instrumentation.…”
Section: Treatment For Csmmentioning
confidence: 99%