Surgery for spinal deformity: non-elective admission status is associated with higher cost of care and longer length of
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Surgery for spinal deformity: non‑elective admission status is associated with higher cost of care and longer length of stay William H. Shuman1 · Emily K. Chapman1 · Jonathan S. Gal2 · Sean N. Neifert1 · Michael L. Martini1 · Alexander J. Schupper1 · Colin D. Lamb1 · Ian T. McNeill1 · Jeffrey Gilligan1 · John M. Caridi1 Received: 6 July 2020 / Accepted: 21 September 2020 © Scoliosis Research Society 2020
Abstract Introduction Surgery is commonly indicated for adult spinal deformity. Annual rates and costs of spinal deformity surgery have both increased over the past two decades. However, the impact of non-elective status on total cost of hospitalization and patient outcomes has not been quantified. Objective To evaluate the impact of admission status on patient outcomes and healthcare costs in spinal deformity surgery. Methods All patients who underwent spinal deformity surgery at a single institution between 2008 and 2016 were grouped by admission status: elective, emergency (ED), or transferred. Demographics were compared by univariate analysis. Cost of care and length of stay (LOS) were compared between admission statuses using multivariable linear regression with elective admissions as reference. Multivariate logistic regression was utilized to assess in-hospital complications, discharge destination, and readmission rates. Results There were 427 spinal deformity surgeries included in this study. Compared to elective patients, ED patients had higher Elixhauser Comorbidity Index scores (p
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