MINIMALLY INVASIVE SURGERY IN SPINAL FUSION - CLINICAL AND ECONOMICAL IMPACT FROM HOSPITAL PERSPECTIVE

Author(s)

Charles YP1, Vouaillat H2, Marcaud M3, Ihara Z41Hôpitaux Universitaires de Strasbourg, Strasbourg, France, 2Clinique des Cèdres, Echirolles, France, 3Medtronic France SAS, Boulogne-Billancourt, France, 4Medtronic International, Tolochenaz, Switzerland

OBJECTIVES: Minimally Invasive Spinal Surgery (MIS) aim at minimizing muscle trauma, reducing blood loss, decreasing postoperative pain, reducing surgery duration and length of stay in hospital (LoS), and accelerate resuming normal activities for the patient. The objective of this study is to determine and compare the resource consumption associated with OS vs. MIS in patients with degenerative spinal disorder treated with a short construct. METHODS: This study was realized in two French hospitals: one public and one private hospital, in which the learning curve could be considered completed. To map the patient flow and estimate resource utilization, the clinical pathways of patients treated with open and MIS spinal instrumentation were defined through interviews with medical staff. The 2009 French Hospitalization Costs Database (ENCC) updated with 2012 DRG tariffs, was used to estimate the unit costs where differences were significant: 1) operating room (OR), 2) LoS, 3) blood consumption. Costs were compared between both pathways (OS vs. MIS), in order to calculate the mean difference of costs. RESULTS: In both hospitals MIS was associated with less resource use especially during surgery and post-surgery episodes. This is mainly due to shorter OR time, LoS and less blood loss. In the public case, 40% decrease in surgery time was observed, 38% reduction in LoS and 100% decrease in blood consumption. In the private hospital, 28% decrease in surgery time, 41% reduction in LoS and 100% decrease in blood consumption. The mean total costs saving associated with MIS corresponds to 1,469€ in the public hospital; and 652€ in the private hospital. CONCLUSIONS: MIS potentially shortens operating and recovery time, decreases blood consumption, and consequently reduces direct medical costs of hospital stays. This reduction may offset the upfront investment (e.g. instrumentation). The findings are consistent with published literature.

Conference/Value in Health Info

2012-11, ISPOR Europe 2012, Berlin, Germany

Value in Health, Vol. 15, No. 7 (November 2012)

Code

PSU12

Topic

Economic Evaluation

Topic Subcategory

Cost-comparison, Effectiveness, Utility, Benefit Analysis

Disease

Musculoskeletal Disorders

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