Lumbar Laminotomy: Variables Affecting 90-day Overall Reimbursement

Area of Science:

• Neurosurgery
• Health Economics
• Healthcare Management

Background:

• Lumbar laminotomy/diskectomy is a common surgical procedure for persistent radiculopathy.
• Understanding cost and reimbursement variability is crucial for optimizing healthcare delivery.
• This study investigates factors influencing reimbursement for this procedure.

Purpose of the Study:

• To assess the variability in reimbursement for single-level lumbar laminotomy/diskectomy.
• To identify key factors associated with reimbursement within 90 days post-surgery.

Main Methods:

• Analysis of 28,621 single-level lumbar laminotomies/diskectomies from 2010-2021.
• Exclusion of pediatric, trauma, oncologic, and infectious cases.
• Multivariable linear regression used to identify factors correlated with reimbursement.

Main Results:

• Average 90-day reimbursement was $9,453.83; median was $3,314.
• Admission (index procedure or readmission) significantly increased reimbursement ($11,757.31 and $31,248.80, respectively).
• Other factors included insurance type, adverse events, ED visits, comorbidity index, and patient age.

Conclusions:

• Substantial variation exists in lumbar laminotomy/diskectomy reimbursement.
• Admission status, insurance, postoperative complications, and ED visits are major cost drivers.
• Balancing inpatient vs. outpatient settings and reducing readmissions can minimize healthcare costs.