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Cost consequence analysis of waiting for lumbar disc herniation surgery
Charlotte Dandurand1, Mohammad Sadegh Mashayekhi2, Greg McIntosh3
1Combined Neurosurgical and Orthopedic Spine Program, Department of Orthopedics Surgery, University of British Columbia, Blusson Spinal Cord Center, 6th Floor, 818 West 10th Avenue, Vancouver, BC, V5Z 1M9, Canada. charlotte.dandurand@vch.ca.
Early lumbar disc surgery significantly reduces societal costs by over $11,000 per patient compared to delayed procedures. While early surgery increases healthcare use, it mitigates long-term productivity losses, proving economically beneficial.
Area of Science:
- Orthopedics
- Health Economics
- Neurosurgery
Background:
- The economic impact of delayed lumbar disc surgery is not well understood.
- Symptomatic disc herniation necessitates timely intervention to optimize patient outcomes and societal costs.
Purpose of the Study:
- To conduct a cost-consequence analysis comparing early (<60 days) versus late (≥60 days) lumbar disc surgery from a societal perspective.
- To evaluate patient factors and patient-reported outcomes in relation to surgical wait times.
Main Methods:
- Retrospective analysis of prospectively collected data from the CSORN registry.
- Cost-consequence analysis comparing direct and indirect costs between short-wait and long-wait surgical groups.
- Inclusion of 493 patients who underwent surgery between January 2015 and October 2021.
Main Results:
- The short-wait group incurred an additional $518.21 in direct costs (increased healthcare utilization) but avoided $11,753.10 in indirect costs per patient.
- No significant difference in return-to-work proportions at 3 and 12 months, though time to return was similar.
- The short-wait group showed a higher proportion achieving minimal clinically important difference in leg pain at 3 months.
Conclusions:
- Early lumbar disc surgery is associated with a net societal cost saving of $11,234.89 per patient compared to late surgery.
- Despite higher initial healthcare utilization, early surgery mitigates long-term productivity losses, particularly for patients with chronic symptoms.
- From a societal economic standpoint, promoting early surgical intervention for lumbar disc herniation is recommended.
