Correlation between health outcome and length of hospital stay in lumbar microdiscectomy.
METHODS
Prospective observational trial in a community hospital setting.


OBJECTIVE
To examine the effect on patient-reported outcome of a clinical practice, namely, decrease in hospital length of stay for single-level lumbar microdiscectomy.


BACKGROUND
Health care reform and the economic demands of managed care have created increasing pressure to manage health care resources more effectively. Spine surgery is one of the most common surgeries.


METHODS
Starting in October 1993, length of stay for patients undergoing lumbar microdiscectomy was decreased at the study institution. Patients completed questionnaires (SF-36) before surgery and 3 months after surgery that assessed health status, back-related functional status, and treatment satisfaction. Comparisons were made between the intervention group and a historical control group and between 1-day and 2-day patients.


RESULTS
SF-36 scores 3 months after surgery approximated age and sex norms of five of the eight SF-36 scales and improved significantly on the remaining three scales. The physical functioning and general health scores were significantly better for the 1-day than the 2-day patients. Patient satisfaction was similar in all groups. Hospital charges for the 1-day patients were $781 less per patient than for the 2-day patients.


CONCLUSIONS
Hospital length of stay for lumbar microdiscectomy can be decreased without adverse effect on short-term patient self-reported health status or satisfaction and with lower hospital charges. This model assesses the effect of efficient management of health care resources on patient-perceived quality and satisfaction.
Lorish
T R
TR
Oregon Spine Center and Rehabilitation Services, Providence St. Vincent Medical Center, Portland, USA.
Tanabe
C T
CT
Waller
F T
FT
London
M R
MR
Lansky
D J
DJ
D000328:Adult; D017586:Diskectomy; D005260:Female; D017048:Health Care Costs; D006764:Hospitals, Community; D006801:Humans; D007902:Length of Stay / Q000191:economics*; D017116:Low Back Pain / Q000191:economics* / Q000601:surgery*; D008159:Lumbar Vertebrae / Q000601:surgery*; D008297:Male; D008329:Managed Care Programs / Q000191:economics / Q000592:standards; D008875:Middle Aged; D017060:Patient Satisfaction; D011446:Prospective Studies; D016896:Treatment Outcome