Theresa Chua, Perry L Lim, Stuart H Hershman, Harold A Fogel, Daniel G Tobert
{"title":"Cervical Laminoplasty Versus Laminectomy and Fusion: A Comprehensive Time-driven Activity-based Cost Analysis.","authors":"Theresa Chua, Perry L Lim, Stuart H Hershman, Harold A Fogel, Daniel G Tobert","doi":"10.1097/BRS.0000000000005150","DOIUrl":null,"url":null,"abstract":"<p><strong>Study design: </strong>Retrospective study.</p><p><strong>Objective: </strong>To compare the true cost between posterior cervical laminectomy and fusion and cervical laminoplasty using time driven activity-based costing methodology.</p><p><strong>Summary of background data: </strong>Cervical laminoplasty (LP) and posterior cervical laminectomy with fusion (LF) are effective procedures for treating cervical myelopathy. A comprehensive accounting of cost differences between LP versus LF is not available. Using time-driven activity-based costing (TDABC), we sought to compare the total facility costs in patients with cervical myelopathy undergoing LP versus LF.</p><p><strong>Materials and methods: </strong>We conducted a retrospective analysis of 277 LP and 229 LF performed between 2019 and 2023. Total facility costs, which included personnel and supply costs, were assessed using TDABC. Separate analyses including and excluding implant costs were performed. Multiple regression analysis was utilized to assess the independent effect of LP compared with LF on facility costs, with all costs standardized using cost units (CUs).</p><p><strong>Results: </strong>Patients undergoing LP had lower total supply costs [672.5 vs. 765.0 CUs (0.88x), P <0.001] and lower total personnel costs [330.0 vs. 830.0 CUs (0.40x), P <0.001], resulting in a lower total facility cost both including [1003.8 vs. 1600.0 CUs (0.63x), P <0.001] and excluding implant costs [770.0 vs. 875.0 CUs (0.88x), P <0.001] (Table 1). After controlling for demographics and comorbidities, LF was associated with increased total facility costs, including (588.5 CUs, 95% CI: 517.1-659.9 CUs, P <0.001) and excluding implant costs (104.3 CUs, 95% CI: 57.6-151.0 CUs, P <0.001).</p><p><strong>Conclusions: </strong>Using time-driven activity-based costing, we found that total facility costs were lower in patients treated with laminoplasty. These findings suggest that laminoplasty may offer a less costly and more efficient surgical option for treating cervical myelopathy.</p>","PeriodicalId":22193,"journal":{"name":"Spine","volume":" ","pages":"1555-1560"},"PeriodicalIF":2.6000,"publicationDate":"2024-11-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Spine","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1097/BRS.0000000000005150","RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2024/9/5 0:00:00","PubModel":"Epub","JCR":"Q2","JCRName":"CLINICAL NEUROLOGY","Score":null,"Total":0}
引用次数: 0
Abstract
Study design: Retrospective study.
Objective: To compare the true cost between posterior cervical laminectomy and fusion and cervical laminoplasty using time driven activity-based costing methodology.
Summary of background data: Cervical laminoplasty (LP) and posterior cervical laminectomy with fusion (LF) are effective procedures for treating cervical myelopathy. A comprehensive accounting of cost differences between LP versus LF is not available. Using time-driven activity-based costing (TDABC), we sought to compare the total facility costs in patients with cervical myelopathy undergoing LP versus LF.
Materials and methods: We conducted a retrospective analysis of 277 LP and 229 LF performed between 2019 and 2023. Total facility costs, which included personnel and supply costs, were assessed using TDABC. Separate analyses including and excluding implant costs were performed. Multiple regression analysis was utilized to assess the independent effect of LP compared with LF on facility costs, with all costs standardized using cost units (CUs).
Results: Patients undergoing LP had lower total supply costs [672.5 vs. 765.0 CUs (0.88x), P <0.001] and lower total personnel costs [330.0 vs. 830.0 CUs (0.40x), P <0.001], resulting in a lower total facility cost both including [1003.8 vs. 1600.0 CUs (0.63x), P <0.001] and excluding implant costs [770.0 vs. 875.0 CUs (0.88x), P <0.001] (Table 1). After controlling for demographics and comorbidities, LF was associated with increased total facility costs, including (588.5 CUs, 95% CI: 517.1-659.9 CUs, P <0.001) and excluding implant costs (104.3 CUs, 95% CI: 57.6-151.0 CUs, P <0.001).
Conclusions: Using time-driven activity-based costing, we found that total facility costs were lower in patients treated with laminoplasty. These findings suggest that laminoplasty may offer a less costly and more efficient surgical option for treating cervical myelopathy.
期刊介绍：
Lippincott Williams & Wilkins is a leading international publisher of professional health information for physicians, nurses, specialized clinicians and students. For a complete listing of titles currently published by Lippincott Williams & Wilkins and detailed information about print, online, and other offerings, please visit the LWW Online Store.
Recognized internationally as the leading journal in its field, Spine is an international, peer-reviewed, bi-weekly periodical that considers for publication original articles in the field of Spine. It is the leading subspecialty journal for the treatment of spinal disorders. Only original papers are considered for publication with the understanding that they are contributed solely to Spine. The Journal does not publish articles reporting material that has been reported at length elsewhere.
求助内容：
应助结果提醒方式：
京公网安备 11010802042870号
