In gratitude of the loyal support of our members, the CNS is offering complimentary 2021 Annual Meeting registration to all members! Learn more.

  • Trends and Disparities in Cervical Spine Fusion Procedure Utilization in the New York State

    Final Number:
    340

    Authors:
    Rui Feng MS; Mark Finkelstein; Eric Karl Oermann MD; Michael Palese MD; John M. Caridi MD

    Study Design:
    Other

    Subject Category:

    Meeting: Congress of Neurological Surgeons 2017 Annual Meeting

    Introduction: There has been a steady increase in spinal fusion procedures performed each year in the US, especially cervical and lumbar fusion. Our study aims to analyze the rate of increase at low-, medium-, and high-volume hospitals, and socioeconomic characteristics of the patient populations at these three volume categories.

    Methods: We searched the New York State, Statewide Planning and Research Cooperative System (SPARCS) database from 2005 to 2014 for the ICD-9-CM Procedure Codes 81.01 (Fusion, atlas-axis), 81.02 (Fusion, anterior column, other cervical, anterior technique), and 81.03 (Fusion, posterior column, other cervical, posterior technique). Patients’ primary diagnosis (ICD-9-CM), age, race/ethnicity, primary payment method, severity of illness, length of stay, hospital of operation were included. We categorized all 122 hospitals high-, medium-, and low-volume. We then described the trends in annual number of cervical spine fusion surgeries in each of the three hospital volume groups using descriptive statistics.

    Results: African American patients were significantly greater portion of patients receiving care at low-volume hospitals, 15.1% versus 11.6% at high-volume hospital. Medicaid and self-pay patients were also overrepresented at low-volume centers, 6.7% and 3.9% versus 2.6% and 1.7% respectively at high-volume centers. In addition, Compared with Caucasian patients, African American patients had higher rates of post-operative infection (p = 0.0020) and post-operative bleeding (p = 0.0044). Compared with privately insured patients, Medicaid patients had a higher rate of post-operative bleeding (p = 0.0266) and in-hospital mortality (p = 0.0031).

    Conclusions: Our results showed significant differences in racial distribution and primary payments methods between the low- and high-volume categories, and suggests that accessibility to care at high-volume centers remains problematic for these disadvantaged populations.

    Patient Care: Our study bring awareness to the racial/ethnic and socioeconomic disparities to access high quality care for cervical spine fusion procedures.

    Learning Objectives: 1. Number of cervical spine fusion procedures continues to increase each year. 2. There are significant disparities in racial distribution and primary payments methods between the low- and high-volume hospitals. 3. Accessibility to care at high-volume centers remains problematic for these disadvantaged populations.

    References:

We use cookies to improve the performance of our site, to analyze the traffic to our site, and to personalize your experience of the site. You can control cookies through your browser settings. Please find more information on the cookies used on our site. Privacy Policy