Comparing Outcomes of Privately Insured Patients Who Underwent Transforaminal Lumbar Interbody Fusion (TLIF) at a Spine Specialty Hospital vs Tertiary Care Hospital

Introduction: Current medical literature lacks quality comparisons of patient reported outcomes (PROs) and perioperative characteristics following spine surgery between tertiary care hospitals (TCH) and spine specialty hospitals (SSH). The objective of this study is to compare PROs, perioperative, and postoperative outcomes of privately insured individuals who underwent transforaminal lumbar interbody fusion (TLIF) surgery at either a SSH or a TCH.

Methods: We retrospectively reviewed a prospectively collected spine surgery quality registry to identify patients who underwent 1-3 level TLIF. We then analyzed PROs including ODI, EQ-5D, EQ-VAS, NRS-LP, NRS-BP at baseline and 1-year. Length of stay and NASS Satisfaction Score were also analyzed at 1-year post-operation. Univariate statistical analyses were performed.

Results: A total of 180 patients (43 from a TCH and 137 from a SSH) were included in the analysis. Baseline demographic characteristics were similarly distributed between the cohorts. There were no statistically significant differences between groups in regards to 1-year PROs, their change from baseline PRO scores, or percentage of patients who met the minimum clinically important difference at 1-year follow up. Length of stay after the procedure was found to be significantly shorter for patients at the SSH than those at the TCH (2.1 ± 0.8 days vs 2.6 ± 1.2 days; p = 0.02).

Conclusion : Based on our findings, SSH may provide similar clinical outcomes while providing the advantage of lower costs for patients and the healthcare system given shorter length of hospital stay.