Outpatient ACDF cost $39K vs. $47K for inpatient surgery: 5 study findings

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Researchers found performing anterior cervical discectomy and fusion procedures in the outpatient setting reduced costs while maintaining patient safety standards, according to an Iowa Orthopedic Journal study.

Study authors reviewed 18,386 patients through the PearlDiver database from 2007 to 2014. Total costs of the procedures and diagnostic tests were determined based on diagnosis to 90-days postoperatively.

Here are five findings:

1. The average 90-day cost in the outpatient setting was $39,528 compared to $47,330 in the inpatient setting.

2. During the study period, reimbursement fell nearly one-third for both groups.

3. In 2008, the cost difference between inpatient and outpatient ACDF was $13,745. However, by 2014, the difference shrank to $3,834.

4. Patients who underwent outpatient surgery experienced a lower incidence of 30-day complications.

5. Around 9.5 percent of outpatients reported 30-day complications compared to 18.6 percent of inpatients.

"Outpatient discharge after ACDF is a viable treatment option with a reasonable safety profile and decreased costs relative to inpatient admission," study authors concluded. "Appropriate patient selection is key, and the standard of care nationally for the comorbid patient remains inpatient admission. The economic trends and epidemiologic data presented here should be useful for health policy decisions."

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