How Well Does Hospital Billing Data Estimate Readmissions and Revision Risks After Spinal Fusion Surgery, Compared to Hospital Billing Linked to Claims Data?
Author(s)
Katherine Corso, MPH1, Anna Wallace, MPH, PhD2, Mingkai Peng, PhD2, Katherine Etter, PhD2, Anshu Gupta, PhD2, Jill Ruppenkamp, MS2, Paul M. Coplan, MBA, MSc, ScD2;
1Johnson & Johnson, Associate Director, Real World Data Analytics and Research, Raynham, MA, USA, 2Johnson & Johnson, New Brunswick, NJ, USA
1Johnson & Johnson, Associate Director, Real World Data Analytics and Research, Raynham, MA, USA, 2Johnson & Johnson, New Brunswick, NJ, USA
Presentation Documents
OBJECTIVES: Hospital databases are used to study medical devices, but cannot follow patients’ healthcare if they don’t return to the same hospital. Claims databases can follow insured patients over time but cannot detect types of medical devices used. Linking hospital and claims databases may strengthen longitudinal follow-up of surgical patients. The study objective was to assess the incremental detection of revision surgery and all-cause readmissions from hospital billing data linked to claims data versus hospital billing data alone among patients that had spinal fusion surgeries.
METHODS: A data quality assessment study was performed. Patients undergoing spinal surgery were identified in a hospital billing database and linked to an administrative claims database. Medicare Advantage insurance and ≥90 days continuous insurance enrollment were required. Cumulative incidence was estimated for 90-day all-cause readmission and 90-, 180-, 365-, and 730-day revision surgery. Analysis was conducted in: (1) hospital database only and (2) linked database.
RESULTS: Overall, 978 patients met inclusion criteria. The revision risk at 90 days was 1.9% in hospital and 2.1% in linked data and at 730 days was 3.3% versus 4.4% in hospital and linked data, respectively. The all-cause readmission risk (90-day) was 20.2% overall in the hospital data and 29.2% in the linked data.
CONCLUSIONS: Preliminary results from this study suggest that the 90-day risks of revision and all-cause readmission were higher in linked data as compared to hospital data alone at 90-days post spinal surgery; however, the difference between risks in the hospital alone versus linked data was greater for readmissions than revisions. Results are consistent with the expectation that patients typically return to the same hospital for revisions of prior procedures, but use various hospitals depending on medical reason, which may have implications for outcome selection according to data source. This study is potentially limited by the completeness of the claims data.
METHODS: A data quality assessment study was performed. Patients undergoing spinal surgery were identified in a hospital billing database and linked to an administrative claims database. Medicare Advantage insurance and ≥90 days continuous insurance enrollment were required. Cumulative incidence was estimated for 90-day all-cause readmission and 90-, 180-, 365-, and 730-day revision surgery. Analysis was conducted in: (1) hospital database only and (2) linked database.
RESULTS: Overall, 978 patients met inclusion criteria. The revision risk at 90 days was 1.9% in hospital and 2.1% in linked data and at 730 days was 3.3% versus 4.4% in hospital and linked data, respectively. The all-cause readmission risk (90-day) was 20.2% overall in the hospital data and 29.2% in the linked data.
CONCLUSIONS: Preliminary results from this study suggest that the 90-day risks of revision and all-cause readmission were higher in linked data as compared to hospital data alone at 90-days post spinal surgery; however, the difference between risks in the hospital alone versus linked data was greater for readmissions than revisions. Results are consistent with the expectation that patients typically return to the same hospital for revisions of prior procedures, but use various hospitals depending on medical reason, which may have implications for outcome selection according to data source. This study is potentially limited by the completeness of the claims data.
Conference/Value in Health Info
2025-05, ISPOR 2025, Montréal, Quebec, CA
Value in Health, Volume 28, Issue S1
Code
RWD87
Topic
Real World Data & Information Systems
Disease
SDC: Musculoskeletal Disorders (Arthritis, Bone Disorders, Osteoporosis, Other Musculoskeletal), STA: Surgery