Economic burden of routine hematologic tests and intensive care unit observation for elective anterior cervical discectomy and fusion
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Updated: May 2, 2026
Anterior Cervical Discectomy and Fusion in the Ovine Model
Published on: October 5, 2009
Insights
Eliminating routine postoperative lab tests and intensive care unit (ICU) stays after anterior cervical discectomy and fusion can reduce healthcare costs by approximately 10% without compromising patient care.
Area of Science:
- Neurosurgery
- Spine Surgery
- Healthcare Economics
Background:
- Anterior cervical discectomy and fusion (ACDF) is a common spinal surgery.
- Healthcare systems face pressure to reduce costs while maintaining patient care quality.
- Routine postoperative hematologic tests and intensive care unit (ICU) stays are potential areas for cost containment in ACDF.
Purpose of the Study:
- To assess the necessity of routine postoperative hematologic tests and ICU stays for ACDF patients.
- To determine if eliminating these practices negatively impacts patient care.
Main Methods:
- Postoperative blood test necessity was based on the need for transfusion or readmission.
- ICU stay necessity was determined by the need for immediate surgical intervention for complications.
- 168 patients undergoing elective ACDF were included.
Main Results:
- No patients required blood transfusions.
- No patients needed immediate surgical intervention for complications during ICU stay.
- All patients received routine preoperative and postoperative blood tests and ICU observation.
Conclusions:
- Routine postoperative laboratory blood studies and observational ICU stays can be eliminated for ACDF patients.
- Elimination of these practices resulted in approximately 10% cost savings per admission.
- Patient care was not compromised by discontinuing unnecessary postoperative tests and ICU observation.
Background:
Anterior cervical discectomy and fusion is one of the most common surgical interventions performed by spine surgeons. As efforts are made to control healthcare spending because of the limited or capped resources offered by the National Health Insurance, surgeons are faced with the challenge of offering high-level patient care while minimizing associated healthcare expenditures. Routine ordering of postoperative hematologic tests and observational intensive care unit (ICU) stay might be areas of potential cost containment. This study was designed to determine the necessity of routine postoperative hematologic tests and ICU stay for patients undergoing elective anterior cervical discectomy and fusion and to investigate whether the elimination of unnecessary postoperative laboratory blood studies and ICU stay inhibits patient care.
Methods:
The necessity for postoperative blood tests was determined if there were needs for a postoperative blood transfusion and hospital readmission within 1 month after surgery. The necessity for postoperative ICU observation was decided if immediate surgical intervention was required when any kind of complications occurred during the ICU stay.
Results:
There were 168 patients collected in the study. Among them, all had routine preoperative and postoperative blood tests and were transferred to ICU for observation. No need for blood transfusion was observed, and no patient required immediate surgical intervention when the complications occurred during the ICU stay.
Conclusion:
Cost savings per admission amounted to approximately 10% of the hospitalization cost by the elimination of unnecessary postoperative routine laboratory blood studies and observational ICU stay without waiving patient care in the current volatile, cost-conscious healthcare environment in Taiwan.
