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Sacroiliac joint fusion health care cost comparison prior to and following surgery: an administrative claims analysis

Authors Buysman EK, Halpern R, Polly DW

Received 13 June 2018

Accepted for publication 15 August 2018

Published 17 October 2018 Volume 2018:10 Pages 643—651

DOI https://doi.org/10.2147/CEOR.S177094

Checked for plagiarism Yes

Review by Single-blind

Peer reviewers approved by Dr Justinn Cochran

Peer reviewer comments 2

Editor who approved publication: Professor Giorgio Lorenzo Colombo


Erin K Buysman,1 Rachel Halpern,1 David W Polly2,3

1Health Economics and Outcomes Research, Optum, Eden Prairie, MN, USA; 2Department of Orthopedic Surgery, University of Minnesota, Minneapolis, MN, USA; 3Department of Neurosurgery, University of Minnesota, Minneapolis, MN, USA

Purpose: To assess real-world expenditures on surgical and non-surgical treatment for sacroiliac joint (SIJ) pain by comparing direct health care costs before and after surgery in patients who underwent an SIJ fusion (SIJF) procedure.
Materials and methods: This retrospective observational study examined administrative claims data (January 1, 2010 to February 28, 2017) for adult commercial health plan members with a medical claim for SIJF. Identified patients were included if they had continuous enrollment in the health plan for 12 months pre-SIJF (baseline period) and 12 months post-SIJF (follow-up period). The outcomes of interest were low back pain-related health care costs in the first three quarters of the baseline period (pre-surgery period; excludes the quarter immediately preceding surgery) and last three quarters of the follow-up period (post-surgery period; excludes the quarter in which SIJF was performed).
Results: Some 302 patients met inclusion criteria: 159 patients had the index SIJF in an inpatient hospital setting, 122 in an outpatient hospital setting, 18 in a surgery center, and three in other settings. Mean and median costs in the pre-surgery period were US$16,803 and US$5,849, respectively, and US$13,297 and US$2,269 in the post-surgery period. Median costs were significantly different in the pre- and post-surgery periods (P<0.001), while mean costs were not. Median health care costs in the pre-surgery and post-surgery periods were lower than the corresponding means due to the highly skewed nature of the cost data.
Conclusion: This health care claims data analysis shows the potential for lower post-operative health care costs compared to pre-operative costs in patients undergoing SIJF. Median low back pain-related costs in the post-surgery period were approximately US$400 per quarter overall and US$250 per quarter for those undergoing SIJF in the non-inpatient setting. Future studies with larger sample sizes and longer follow-up will improve the precision of the cost data.

Keywords:
low back pain, pre-surgery expenditures, post-surgery expenditures

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