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Surgery for herniated lumbar disc in private vs public hospitals: A pragmatic comparative effectiveness study
Mattis A Madsbu1,2, Øyvind Salvesen3, Sven M Carlsen4,5
1Department of Neurosurgery, St. Olavs University Hospital, Trondheim, Norway. mattis.madsbu@gmail.com.
Acta Neurochirurgica
|January 6, 2020
Summary
Surgery for lumbar disc herniation (LDH) showed equivalent outcomes in private and public hospitals. This study compared patient recovery and complications, finding no significant differences in effectiveness between healthcare settings.
Area of Science:
- Orthopedics
- Health Services Research
- Comparative Effectiveness
Background:
- Limited comparative data exists for private vs. public healthcare performance.
- Evaluating surgical outcomes for lumbar disc herniation (LDH) is crucial.
Purpose of the Study:
- To compare surgical outcomes for LDH between private and public hospitals.
- To assess functional improvement, quality of life, pain, and complications.
Main Methods:
- Utilized data from the Norwegian registry for spine surgery.
- Primary outcome: Oswestry disability index (ODI) at 1 year.
- Secondary outcomes: EQ-5D, pain, complications, surgery duration, and hospital stay.
Main Results:
- Equivalent improvement in ODI between private and public hospitals (mean difference -3.5 points).
- No significant differences in leg pain or complications after propensity matching.
- Shorter surgery duration and hospital stay observed in private clinics.
Conclusions:
- Surgical effectiveness for LDH is equivalent in private and public hospitals at 1-year follow-up.
- While some initial differences in secondary outcomes existed, they were mitigated by propensity matching.
