Cost-effectiveness of discectomy
Discectomy is the most commonly performed spine surgery. Since no studies have been conducted to evaluate the cost-effectiveness of adopting this procedure, this economic study was designed to investigate the cost-effectiveness of outpatient lumbar discectomy compared to inpatient care.
The hospital perspective was taken into account.
cost utility study, medical costs were obtained from an evaluation of 20 patients who underwent outpatient lumbar discectomy and 20 patients who underwent inpatient lumbar discectomy.
Quality-adjusted survival years were calculated from Oswestry Disability Index values (ODIs), and ODIs were prospectively assessed at preoperative, 3-month and 6-month postoperative assessments in outpatients.
ODI data for inpatients were estimated from meta-analyses, probabilistic sensitivity analyses were performed, and incremental cost-effectiveness ratios (ICERs) were calculated.
Results.
Outpatient care was found to save costs in all models tested.
At the 3-month evaluation, ICERs ranged from €135,753 to €345,755 / QALY, which is higher than the predefined threshold of €60,000 / QALY.
In terms of 6-month costs, outpatient costs were low and utilities were high, overwhelming the inpatient procedure. Probabilistic sensitivity analysis showed that outpatient was the better option in 65-73% of the simulations. Outpatient savings were about 55% of the inpatient value, with similar utility scores. No 30-day readmissions were recorded in either group.
In conclusion, this is the first study to show that adopting discectomy can result in significant savings in terms of cost-effectiveness.
Linhares, D., Fonseca, J.A., Ribeiro da Silva, M. et al. Cost effectiveness of outpatient lumbar discectomy. Cost Eff Resour Alloc 19, 19 (2021). Available at: https://doi.org/10.1186/s12962-021-00272-w
Summary
In this study, the focus was on "cost effectiveness" and the conclusion was that it was cheaper to adopt surgery. The conclusion was that surgery was cheaper than conservative treatment. Although we don't know if the results are true, it can be an option when considering treatment.
Since the amount of money is not as high as the result, it may be a good idea to consider the cost when actually considering treatment related to the disc.
