AI Article Synopsis

  • - The study examined the factors affecting the length of stay (LOS) for patients undergoing elective lumbar laminectomy in a hospital context, particularly focusing on both clinical and nonclinical influences on patient outcomes and costs.
  • - Analyzing data from 1,359 patients treated between March 2016 and February 2019, researchers found that average LOS ranged from 2.01 to 2.47 days based on the day of surgery, with longer stays linked to discharges to skilled nursing facilities or rehabilitation centers.
  • - The study revealed that surgeries performed later in the week incurred significantly higher costs, with LOS not correlating with greater health risks, but influenced by factors like patient comorbidities and the type of

Article Abstract

Objective: In a healthcare landscape in which costs increasingly matter, the authors sought to distinguish among the clinical and nonclinical drivers of patient length of stay (LOS) in the hospital following elective lumbar laminectomy-a common spinal surgery that may be reimbursed using bundled payments-and to understand their relationships with patient outcomes and costs.

Methods: Patients ≥ 18 years of age undergoing laminectomy surgery for degenerative lumbar spinal stenosis within the Cleveland Clinic health system between March 1, 2016, and February 1, 2019, were included in this analysis. Generalized linear modeling was used to assess the relationships between the day of surgery, patient discharge disposition, and hospital LOS, while adjusting for underlying patient health risks and other nonclinical factors, including the hospital surgery site and health insurance.

Results: A total of 1359 eligible patients were included in the authors' analysis. The mean LOS ranged between 2.01 and 2.47 days for Monday and Friday cases, respectively. The LOS was also notably longer for patients who were ultimately discharged to a skilled nursing facility (SNF) or rehabilitation center. A prolonged LOS occurring later in the week was not associated with greater underlying health risks, yet it nevertheless resulted in greater costs of care: the average total surgical costs for lumbar laminectomy were 20% greater for Friday cases than for Monday cases, and 24% greater for late-week cases than for early-week cases ultimately transferred to SNFs or rehabilitation centers. A Poisson generalized linear model fit the data best and showed that the comorbidity burden, surgery at a tertiary care center versus a community hospital, and the incidence of any postoperative complication were associated with significantly longer hospital stays. Discharge to home healthcare, SNFs, or rehabilitation centers, and late-week surgery were significant nonclinical predictors of LOS prolongation, even after adjusting for underlying patient health risks and insurance, with LOSs that were, for instance, 1.55 and 1.61 times longer for patients undergoing their procedure on Thursday and Friday compared to Monday, respectively.

Conclusions: Late-week surgeries are associated with a prolonged LOS, particularly when discharge is to an SNF or rehabilitation center. These findings point to opportunities to lower costs and improve outcomes associated with elective surgical care. Interventions to optimize surgical scheduling and perioperative care coordination could help reduce prolonged LOSs, lower costs, and, ultimately, give service line management personnel greater flexibility over how to use existing resources as they remain ahead of healthcare reforms.

Download full-text PDF

Source
http://dx.doi.org/10.3171/2020.11.SPINE201403DOI Listing

Publication Analysis

Top Keywords

health risks
12
late-week surgery
8
elective lumbar
8
lumbar laminectomy
8
generalized linear
8
adjusting underlying
8
underlying patient
8
patient health
8
friday cases
8
longer patients
8

Similar Publications

Association of retinal microvascular abnormalities with all-cause and specific-cause mortality among U.S. adults.

BMC Public Health

December 2024

State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Centre, Guangdong Provincial Key Laboratory of Ophthalmology and Visual Science, Sun Yat-Sen University, Guangzhou, 510060, China.

Background: Retinal microvascular abnormalities (RMA) reflect cumulative microvascular damage from systemic diseases and aging. However, little is known about the association between RMA and long-term survival outcomes. This study aimed to examine the relationships between RMA and the risk of all-cause and specific-cause mortality among U.

View Article and Find Full Text PDF

Background: This study aimed to investigate the relationship between the composite dietary antioxidant index (CDAI) and rheumatoid arthritis (RA) using data from the National Health and Nutrition Examination Survey (NHANES) spanning from 2001 to 2020.

Methods: CDAI is based on the intake of vitamins A, C, E, manganese, selenium, and zinc from the diet. RA patients were identified through questionnaire responses.

View Article and Find Full Text PDF

Non-linear association of sleep duration with osteoarthritis among U.S. middle-aged and older adults.

BMC Public Health

December 2024

Wangjing Hospital, China Academy of Chinese Medical Sciences, No. 6, Zhonghuan South Road, Chaoyang District, Beijing, 100102, China.

Background: The duration of sleep is linked to a range of disorders. Osteoarthritis (OA) stands as one of the most prevalent forms of arthritis and serves as a leading cause of disability. The correlation between the duration of sleep and OA remains ambiguous.

View Article and Find Full Text PDF

Attenuated sex-related DNA methylation differences in cancer highlight the magnitude bias mediating existing disparities.

Biol Sex Differ

December 2024

State Key Laboratory of Genetic Engineering, School of Life Sciences, Human Phenome Institute, Fudan University, Shanghai, China.

Background: DNA methylation (DNAm) influences both sex differences and cancer development, yet the mechanisms connecting these factors remain unclear.

Methods: Utilizing data from The Cancer Genome Atlas, we conducted a comprehensive analysis of sex-related DNAm effects in nine non-reproductive cancers, compared to paired normal adjacent tissues (NATs), and validated the results using independent datasets. First, we assessed the extent of sex differential DNAm between cancers and NATs to explore how sex-related DNAm differences change in cancerous tissues.

View Article and Find Full Text PDF

Background: Preeclampsia is a severe pregnancy complication affecting 2-8% of pregnancies globally, contributing to substantial maternal and fetal morbidity and mortality. Vitamin D deficiency has been associated with an increased risk of preeclampsia, yet the efficacy of its supplementation during pregnancy in reducing preeclampsia incidence remains uncertain.

Objectives: This systematic review and meta-analysis aimed to evaluate the impact of vitamin D supplementation on the incidence of preeclampsia and related maternal and neonatal outcomes.

View Article and Find Full Text PDF

Want AI Summaries of new PubMed Abstracts delivered to your In-box?

Enter search terms and have AI summaries delivered each week - change queries or unsubscribe any time!

A PHP Error was encountered

Severity: Notice

Message: fwrite(): Write of 34 bytes failed with errno=28 No space left on device

Filename: drivers/Session_files_driver.php

Line Number: 272

Backtrace:

A PHP Error was encountered

Severity: Warning

Message: session_write_close(): Failed to write session data using user defined save handler. (session.save_path: /var/lib/php/sessions)

Filename: Unknown

Line Number: 0

Backtrace: