Epidemiologic and Economic Burden Attributable to First Spinal Fusion Surgery: Analysis From an Italian Administrative Database

P. A. Cortesi, R. Assietti, F. Cuzzocrea, D. Prestamburgo, M. Pluderi, P. Cozzolino, P. Tito, R. Vanelli, D. Cecconi, S. Borsa, G. Cesana, L. G. Mantovani

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Abstract

STUDY DESIGN: Retrospective large population based-study. OBJECTIVE: Assessment of the epidemiologic trends and economic burden of first spinal fusions. SUMMARY OF BACKGROUND DATA: No adequate data are available regarding the epidemiology of spinal fusion surgery and its economic impact in Europe. METHODS: The study population was identified through a data warehouse (DENALI), which matches clinical and economic data of different Healthcare Administrative databases of the Italian Lombardy Region. The study population consisted of all subjects, resident in Lombardy, who, during the period January 2001 to December 2010, underwent spinal fusion surgery (ICD-9-CM codes: 81.04, 81.05, 81.06, 81.07, and 81.08). The first procedure was used as the index event. We estimated the incidence of first spinal fusion surgery, the population and surgery characteristics and the healthcare costs from the National Health Service's perspective. The analysis was performed for the entire population and divided into the main groups of diagnosis. RESULTS: The analysis identified 17,772 [mean age (SD): 54.6 (14.5) years, 55.3% females] spinal fusion surgeries. Almost 67% of the patients suffered from a lumbar degenerative disease. The incidence rate of interventions increased from 11.5 to 18.5 per 100,000 person-year between 2001 and 2006, and was above 20.0 per 100,000 person-year in the last 4 years. The patients' mean age increased during the observational time period from 48.1 to 55.9 years; whereas the median hospital length of stay reported for the index event decreased. The average cost of the spinal fusion surgery increased during the observational period, from &OV0556; 4726 up to &OV0556; 9388. CONCLUSION: The study showed an increasing incidence of spinal fusion surgery and costs from 2001 to 2010. These results can be used to better understand the epidemiological and economic burden of these interventions, and help to optimize the resources available considering the different clinical approaches accessible today. LEVEL OF EVIDENCE: 4.
Original languageEnglish
Pages (from-to)1398-1404
Number of pages7
JournalSpine
Volume42
Issue number18
DOIs
Publication statusPublished - Sep 15 2017

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Spinal Fusion
Economics
Databases
Population
Length of Stay
Incidence
Costs and Cost Analysis
National Health Programs
International Classification of Diseases
Population Characteristics
Health Care Costs
Epidemiology
Delivery of Health Care

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Epidemiologic and Economic Burden Attributable to First Spinal Fusion Surgery: Analysis From an Italian Administrative Database. / Cortesi, P. A.; Assietti, R.; Cuzzocrea, F.; Prestamburgo, D.; Pluderi, M.; Cozzolino, P.; Tito, P.; Vanelli, R.; Cecconi, D.; Borsa, S.; Cesana, G.; Mantovani, L. G.

In: Spine, Vol. 42, No. 18, 15.09.2017, p. 1398-1404.

Research output: Contribution to journalArticle

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title = "Epidemiologic and Economic Burden Attributable to First Spinal Fusion Surgery: Analysis From an Italian Administrative Database",
abstract = "STUDY DESIGN: Retrospective large population based-study. OBJECTIVE: Assessment of the epidemiologic trends and economic burden of first spinal fusions. SUMMARY OF BACKGROUND DATA: No adequate data are available regarding the epidemiology of spinal fusion surgery and its economic impact in Europe. METHODS: The study population was identified through a data warehouse (DENALI), which matches clinical and economic data of different Healthcare Administrative databases of the Italian Lombardy Region. The study population consisted of all subjects, resident in Lombardy, who, during the period January 2001 to December 2010, underwent spinal fusion surgery (ICD-9-CM codes: 81.04, 81.05, 81.06, 81.07, and 81.08). The first procedure was used as the index event. We estimated the incidence of first spinal fusion surgery, the population and surgery characteristics and the healthcare costs from the National Health Service's perspective. The analysis was performed for the entire population and divided into the main groups of diagnosis. RESULTS: The analysis identified 17,772 [mean age (SD): 54.6 (14.5) years, 55.3{\%} females] spinal fusion surgeries. Almost 67{\%} of the patients suffered from a lumbar degenerative disease. The incidence rate of interventions increased from 11.5 to 18.5 per 100,000 person-year between 2001 and 2006, and was above 20.0 per 100,000 person-year in the last 4 years. The patients' mean age increased during the observational time period from 48.1 to 55.9 years; whereas the median hospital length of stay reported for the index event decreased. The average cost of the spinal fusion surgery increased during the observational period, from &OV0556; 4726 up to &OV0556; 9388. CONCLUSION: The study showed an increasing incidence of spinal fusion surgery and costs from 2001 to 2010. These results can be used to better understand the epidemiological and economic burden of these interventions, and help to optimize the resources available considering the different clinical approaches accessible today. LEVEL OF EVIDENCE: 4.",
author = "Cortesi, {P. A.} and R. Assietti and F. Cuzzocrea and D. Prestamburgo and M. Pluderi and P. Cozzolino and P. Tito and R. Vanelli and D. Cecconi and S. Borsa and G. Cesana and Mantovani, {L. G.}",
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T1 - Epidemiologic and Economic Burden Attributable to First Spinal Fusion Surgery: Analysis From an Italian Administrative Database

AU - Cortesi, P. A.

AU - Assietti, R.

AU - Cuzzocrea, F.

AU - Prestamburgo, D.

AU - Pluderi, M.

AU - Cozzolino, P.

AU - Tito, P.

AU - Vanelli, R.

AU - Cecconi, D.

AU - Borsa, S.

AU - Cesana, G.

AU - Mantovani, L. G.

N1 - LR: 20170913; JID: 7610646; 2017/02/12 06:00 [pubmed]; 2017/02/12 06:00 [medline]; 2017/02/11 06:00 [entrez]; ppublish

PY - 2017/9/15

Y1 - 2017/9/15

N2 - STUDY DESIGN: Retrospective large population based-study. OBJECTIVE: Assessment of the epidemiologic trends and economic burden of first spinal fusions. SUMMARY OF BACKGROUND DATA: No adequate data are available regarding the epidemiology of spinal fusion surgery and its economic impact in Europe. METHODS: The study population was identified through a data warehouse (DENALI), which matches clinical and economic data of different Healthcare Administrative databases of the Italian Lombardy Region. The study population consisted of all subjects, resident in Lombardy, who, during the period January 2001 to December 2010, underwent spinal fusion surgery (ICD-9-CM codes: 81.04, 81.05, 81.06, 81.07, and 81.08). The first procedure was used as the index event. We estimated the incidence of first spinal fusion surgery, the population and surgery characteristics and the healthcare costs from the National Health Service's perspective. The analysis was performed for the entire population and divided into the main groups of diagnosis. RESULTS: The analysis identified 17,772 [mean age (SD): 54.6 (14.5) years, 55.3% females] spinal fusion surgeries. Almost 67% of the patients suffered from a lumbar degenerative disease. The incidence rate of interventions increased from 11.5 to 18.5 per 100,000 person-year between 2001 and 2006, and was above 20.0 per 100,000 person-year in the last 4 years. The patients' mean age increased during the observational time period from 48.1 to 55.9 years; whereas the median hospital length of stay reported for the index event decreased. The average cost of the spinal fusion surgery increased during the observational period, from &OV0556; 4726 up to &OV0556; 9388. CONCLUSION: The study showed an increasing incidence of spinal fusion surgery and costs from 2001 to 2010. These results can be used to better understand the epidemiological and economic burden of these interventions, and help to optimize the resources available considering the different clinical approaches accessible today. LEVEL OF EVIDENCE: 4.

AB - STUDY DESIGN: Retrospective large population based-study. OBJECTIVE: Assessment of the epidemiologic trends and economic burden of first spinal fusions. SUMMARY OF BACKGROUND DATA: No adequate data are available regarding the epidemiology of spinal fusion surgery and its economic impact in Europe. METHODS: The study population was identified through a data warehouse (DENALI), which matches clinical and economic data of different Healthcare Administrative databases of the Italian Lombardy Region. The study population consisted of all subjects, resident in Lombardy, who, during the period January 2001 to December 2010, underwent spinal fusion surgery (ICD-9-CM codes: 81.04, 81.05, 81.06, 81.07, and 81.08). The first procedure was used as the index event. We estimated the incidence of first spinal fusion surgery, the population and surgery characteristics and the healthcare costs from the National Health Service's perspective. The analysis was performed for the entire population and divided into the main groups of diagnosis. RESULTS: The analysis identified 17,772 [mean age (SD): 54.6 (14.5) years, 55.3% females] spinal fusion surgeries. Almost 67% of the patients suffered from a lumbar degenerative disease. The incidence rate of interventions increased from 11.5 to 18.5 per 100,000 person-year between 2001 and 2006, and was above 20.0 per 100,000 person-year in the last 4 years. The patients' mean age increased during the observational time period from 48.1 to 55.9 years; whereas the median hospital length of stay reported for the index event decreased. The average cost of the spinal fusion surgery increased during the observational period, from &OV0556; 4726 up to &OV0556; 9388. CONCLUSION: The study showed an increasing incidence of spinal fusion surgery and costs from 2001 to 2010. These results can be used to better understand the epidemiological and economic burden of these interventions, and help to optimize the resources available considering the different clinical approaches accessible today. LEVEL OF EVIDENCE: 4.

U2 - 10.1097/BRS.0000000000002118 [doi]

DO - 10.1097/BRS.0000000000002118 [doi]

M3 - Article

VL - 42

SP - 1398

EP - 1404

JO - Spine

JF - Spine

SN - 0362-2436

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