Long-term health care utilisation and costs after spinal fusion in elderly patients

Andersen TB, Bünger C, Søgaard R.
Purpose Spinal fusion surgery rates in the elderly are
increasing. Cost effectiveness analyses with relatively
short-length follow-up have been performed. But the longterm
effects in terms of health care use are largely
unknown. The aim of the present study was to describe the
long-term consequences of spinal fusion surgery in elderly
patients on health care use and costs using a health care
system perspective.
Methods 194 patients undergoing spinal fusion between
2001 and 2005 (70 men, 124 women) with a mean age of
70 years (range 59–88) at surgery were included. Average
length of follow-up was 6.2 years (range 0.3–9.0 years).
Data on resource utilisation and costs were obtained from
national registers providing complete coverage of all
reimbursed contacts with primary- and secondary health
care providers. Data were available from 3 years prior
fusion surgery until the end of 2009.
Results Use of hospital-based health care increased in the
year prior to and the first year following surgery. Hereafter
it normalised to the level of the background population and
was mainly composed of diseases unrelated to the spine. In
contrast, the use of primary health care appeared to
increase immediately after surgery and continued to
increase to a level that significantly exceeded that of the
background population. It could be demonstrated that the
increase was mainly due to an increasing number of general
practitioner consultations.
Conclusion Spinal fusion surgery in older patients does
not generate excess hospital-based health care use in the
longer term as compared with the background population,
but primary care use increases.

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Udgivelsesform Videnskabelige artikler
År 2012
Udgiver Eur Spine J