Evidence & Methods
Cost analyses are being increasingly performed given the costs of health care. In this article, the authors compare costs of anterior-posterior (AP) fusion versus transforaminal lumbar interbody fusion (TLIF).
The mean hospital costs were slightly higher for AP fusion versus TLIF, but the payment received by the hospital was greater for AP fusions.
This study has significant limitations that may limit generalization including retrospective design, unmatched controls, failure to assess costs outside of the hospital perspective, assumed contribution margin, single institution, presumed equivalent clinical outcomes (eg, infection rates, readmission rates, DVT rates), and so on. That said, the hospital perspective is an interesting one given that bundled payments to hospitals appear to be integral to the federal government's shift from a “volume” to “quality” reimbursement model. The article should serve as a nidus to prospective-controlled studies.
—The Editors