Before entering bundled payment agreements, providers should understand costs associated with certain patient, hospital and procedure characteristics, according to a study published on Medscape.
Researchers studied 134,088 U.S. patients who underwent elective anterior cervical discectomy and fusion in 2011, and estimated how certain factors influenced costs and length of stay.
Five findings:
1. Nearly one-third of patients who underwent ACDF had no comorbidities. However, 18.7 percent had three or more comorbidities. Hypertension, renal disease and depression were among the most prevalent conditions.
2. The average cost of ACDF for hospitals was $18,622, and the average length of stay after ACDF was 1.7 days.
3. Hospitals' marginal costs rose $17,181 with inpatient death, $8,351 for patients with recent weight loss and $6,129 with metastatic cancer. Each factor was associated with a longer length of stay.
4. Costs and length of stay were the highest when a posterior fusion/instrumentation, revision anterior surgery or fusion of more than three levels occurred.
5. Average cost and length of stay were the highest among patients in the Western U.S., at $9,300 and 0.3 days more, respectively.
"Hospital costs and [length of stay] after ACDF rise with increasing patient comorbidities. Stakeholders entering into bundled payments should be aware of that certain patient, hospital and procedure characteristics will consume greater resources," researchers concluded.