Outpatient vs Inpatient Anterior Cervical Discectomy and Fusion: A Population-Level Analysis of Outcomes and Cost

Neurosurgery
David A PurgerAtman Desai

Abstract

Outpatient anterior cervical discectomy and fusion (ACDF) is a promising candidate for US healthcare cost reduction as several studies have demonstrated that overall complications are relatively low and early discharge can preserve high patient satisfaction, low morbidity, and minimal readmission. To compare clinical outcomes and associated costs between inpatient and ambulatory setting ACDF. Demographics, comorbidities, emergency department (ED) visits, readmissions, reoperation rates, and 90-d charges were retrospectively analyzed for patients undergoing elective ACDF in California, Florida, and New York from 2009 to 2011 in State Inpatient and Ambulatory Databases. A total of 3135 ambulatory and 46 996 inpatient ACDFs were performed. Mean Charlson comorbidity index, length of stay, and mortality were 0.2, 0.4 d, and 0% in the ambulatory cohort and 0.4, 1.8 d, and 0.04% for inpatients (P < .0001). Ambulatory patients were younger (48.0 vs 53.1) and more likely to be Caucasian. One hundred sixty-eight ambulatory patients (5.4%) presented to the ED within 30 d (mean 11.3 d), 51 (1.6%) were readmitted, and 5 (0.2%) underwent reoperation. Among inpatient surgeries, 2607 patients (5.5%) presented to the ED within 30 d (mean 9.7 d)...Continue Reading

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Citations

May 2, 2018·Neurosurgical Focus·Arjun Vivek PendharkarAtman Mukesh Desai
Apr 28, 2018·Journal of Neurosurgery. Pediatrics·K Aaron ShawJoshua S Murphy
Jun 11, 2019·Clinical Spine Surgery : a Spine Publication·David A PurgerAtman M Desai
May 22, 2020·Global Spine Journal·Teja R KarukondaIsaac L Moss
Jan 15, 2020·Global Spine Journal·Christopher D WitiwVincent C Traynelis
Jan 12, 2021·The Journal of the American Academy of Orthopaedic Surgeons·Glenn S RussoChristopher K Kepler
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Apr 24, 2021·Global Spine Journal·Ilyas EliZoher Ghogawala
Jun 14, 2021·Journal of Clinical Neuroscience : Official Journal of the Neurosurgical Society of Australasia·David J MaulerMichael A Bohl

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