Cost Analysis of Outpatient Anterior Cervical Discectomy and Fusion at an Academic Medical Center without Dedicated Ambulatory Surgery Centers.

World Neurosurgery
Michael M SafaeeAaron J Clark

Abstract

Anterior cervical discectomy and fusion (ACDF) are increasingly performed at ambulatory surgical centers (ASCs). Academic centers lacking dedicated ASCs must perform these at large university hospitals, which pose unique challenges to cost savings and efficiency. To describe the safety and cost of outpatient ACDF at a major academic medical center without a dedicated ASC. ACDFs performed from 2015 to 2018 were retrospectively reviewed. Cases were performed at the major tertiary university hospital or a satellite university hospital dedicated to outpatient surgery. Patient demographics, surgical characteristics, perioperative complications, fusion at 12 months, and cost were collected. A total of 470 patients were included. The mean age was 56 years, with 255 women (54.3%). When comparing same-day discharge, overnight observation, or inpatient admission, there were no differences in age, gender, or number of levels fused. Same-day and overnight observation cases were associated with shorter procedure duration and less estimated blood loss. There were no differences in perioperative complications, 30-day readmissions, or fusion at 12 months. Direct and total costs were lowest for same-day cases, followed by overnight observation ...Continue Reading

References

Jan 8, 2010·Annals of Surgery·Eric MuñozLeslie Wise
Mar 11, 2010·Spine·Satyajit MarawarStavros G Memtsoudis
Jun 5, 2010·Journal of Clinical Anesthesia·Alex Macario
Oct 30, 2016·The Journal of the American Academy of Orthopaedic Surgeons·Peter D FabricantTheodore J Ganley
Mar 1, 2018·JAMA Surgery·Christopher P Childers, Melinda Maggard-Gibbons
Apr 2, 2019·Neurosurgical Focus·Mazin ElsarragM Yashar S Kalani
Jul 6, 2019·World Neurosurgery·Nicholas DietzMaxwell Boakye

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