Less complications and reduced health care costs: For spine surgery it’s better go to a specialist
A recent study demonstrated the direct correlation between the number of spine surgeries that a physician has carried out and the complication rate. Clear conclusion: the more interventions a surgeon carries out on average, the lower the complication rate and the lower the health care costs.
A work group from Maryland (USA) analyzed a huge data set for the years 1992-2005. 232,668 hospitalizations for “posterolateral lumbar decompression with fusion and/or exploration/decompression of the spinal canal” were assigned to the respective hospitals and surgeons. All clinics and physicians were divided into four groups (quartiles) according to the number of interventions. Quartile 1 represented the hospitals or physicians with the lowest number of surgeries and the fourth quartile those with the most referrals.
The results were unequivocal: the patients were best off in the hospitals or with the physicians from the fourth quartile. They experienced less frequent complications and could leave the hospital on average 7 days earlier than their fellow sufferers from the first quartile.
Of great importance to the health care system are the reduced costs associated with the treatment by specialists. Altogether the hospital costs were about 45% reduced in the fourth quartile compared to quartile 1.
In the hands of experienced spine-surgeons the patients recovered more quickly and could be discharged home on average 7 days earlier.
The patients were best off with the surgeons that carried out the most interventions. They experienced significantly less complications.
Source: Farjoodi et al. (2011) The Effects of Hospital and Surgeon Volume on Postoperative Complications After Lumbar Spine Surgery. Spine Journal: epub ahead of print