Journal ArticleDOI
Economic impact of improving outcomes of lumbar discectomy.
John E. Sherman,Joseph C. Cauthen,Doug Schoenberg,Matthew M. Burns,Nancy L. Reaven,Steven L. Griffith +5 more
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TLDR
Surgical technologies that can improve outcomes of discectomy by 50% to 70% thus improving patient quality of life can be overall cost-neutral between $971 and $1,655 additionally per patient.About:
This article is published in The Spine Journal.The article was published on 2010-02-01. It has received 88 citations till now. The article focuses on the topics: Discectomy & Cost effectiveness.read more
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Rehabilitation after lumbar disc surgery
Teddy Oosterhuis,Leonardo Oliveira Pena Costa,Christopher G. Maher,Henrica C.W. de Vet,Maurits W. van Tulder,Raymond W. J. G. Ostelo +5 more
TL;DR: Low- to very low-quality evidence suggests that physiotherapy from four to six weeks postsurgery onward led to better function than no treatment or education only, and that multidisciplinary rehabilitation co-ordinated by medical advisors led to faster return to work than usual care.
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Outpatient surgery reduces short-term complications in lumbar discectomy: an analysis of 4310 patients from the ACS-NSQIP database.
TL;DR: In this article, the authors compared the incidence of complications in patients undergoing single-level lumbar discectomy between the inpatient and outpatient settings, to determine baseline 30-day complication rates, and to identify independent risk factors for complications.
Journal ArticleDOI
Prospective, multicenter, randomized, controlled study of anular repair in lumbar discectomy: two-year follow-up.
TL;DR: This multicenter randomized study demonstrated that anular repair reduced the need for subsequent reherniation surgery while retaining the benefits of discectomy with no increased risk for patients.
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Repeat surgery after lumbar decompression for herniated disc: the quality implications of hospital and surgeon variation
Brook I. Martin,Sohail K. Mirza,David R. Flum,Thomas M. Wickizer,Patrick J. Heagerty,Alex Lenkoski,Richard A. Deyo +6 more
TL;DR: Even after adjusting for patient demographics and comorbidity, a large variation in reoperation rates across hospitals and surgeons after lumbar discectomy, a relatively simple spinal procedure is observed, suggesting uncertainty about indications for repeat surgery, variations in perioperative care, or variations in quality of care.
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An analysis from the Quality Outcomes Database, Part 2. Predictive model for return to work after elective surgery for lumbar degenerative disease.
Anthony L. Asher,Clinton J. Devin,Kristin R. Archer,Silky Chotai,Scott L. Parker,Mohamad Bydon,Hui Nian,Frank E. Harrell,Theodore Speroff,Theodore Speroff,Robert S. Dittus,Robert S. Dittus,Sharon E. Philips,Christopher I. Shaffrey,Kevin T Foley,Matthew J. McGirt +15 more
TL;DR: A novel predictive model of patients' ability to RTW after undergoing lumbar spine surgery for degenerative spine disease is presented, which can be used to educate patients and encourage them in shared decision-making regarding the RTW outcome.
References
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Journal ArticleDOI
Foundations of cost-effectiveness analysis for health and medical practices.
Abstract: Limits on health-care resources mandate that resource-allocation decisions be guided by considerations of cost in relation to expected benefits. In cost-effectiveness analysis, the ratio of net health-care costs to net health benefits provides an index by which priorities may be set. Quality-of-life concerns, including both adverse and beneficial effects of therapy, may be incorporated in the calculation of health benefits as adjustments to life expectancy. The timing of future benefits and costs may be accounted for by the appropriate use of discounting. Current decisions must inevitably be based on imperfect information, but sensitivity analysis can increase the level of confidence in some decisions while suggesting areas where further research may be valuable in guiding others. Analyses should be adaptable to the needs of various health-care decision makers, including planners, administrators and providers.
Journal Article
How attractive does a new technology have to be to warrant adoption and utilization? Tentative guidelines for using clinical and economic evaluations
TL;DR: In this article, four levels of evidence that rate economic evaluations on the basis of their methodologic rigour are proposed, based on the quality of the methods used to estimate clinical effectiveness, quality of life and costs.
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Lumbar disc herniation. A controlled, prospective study with ten years of observation.
TL;DR: The controlled trial showed a statistically significant better result in the surgically treated group at the one-year follow-up examination, but after four years the operated patients still showed better results, but the difference was no longer statistically significant.
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Surgical vs Nonoperative Treatment for Lumbar Disk Herniation: The Spine Patient Outcomes Research Trial (SPORT): A Randomized Trial
James Neil Weinstein,Tor D. Tosteson,Jon D. Lurie,Anna N. A. Tosteson,Brett Hanscom,Jonathan Skinner,William A. Abdu,Alan S. Hilibrand,Scott D. Boden,Richard A. Deyo +9 more
TL;DR: Patients in both the surgery and the nonoperative treatment groups improved substantially over a 2-year period, and conclusions about the superiority or equivalence of the treatments are not warranted based on the intent-to-treat analysis.
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Clinical Economics: A Guide to the Economic Analysis of Clinical Practices
TL;DR: By understanding economic analysis, physicians will be able to act as patient advocates and fulfill their responsibilities to society to manage resources prudently, Eisenberg believes.