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Monthly multidisciplinary complex spine conference: a cost-analysis utilizing time-driven activity-based costing.

Rajiv Sethi1,2,3, Philip Louie4, Aiyush Bansal4

  • 1Department of Neurosurgery, Center for Neuroscience and Spine, Virginia Mason Medical Center, Seattle, WA, USA. sethir@uw.edu.

Spine Deformity
|December 16, 2023
PubMed
Summary

Implementing a multidisciplinary conference for adult spinal deformity significantly reduces complications and costs. This approach saves nearly $400,000 annually by improving patient care and optimizing resource allocation.

Keywords:
Adult spinal deformityLean methodologyMultidisciplinary conferenceSpineTDABCValue-based care

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Area of Science:

  • Healthcare Management
  • Spine Surgery
  • Cost-Effectiveness Analysis

Background:

  • Managing complex spinal disorders requires efficient and cost-effective strategies.
  • Multidisciplinary conferences are crucial for optimizing patient care pathways.
  • Previous models lacked comprehensive cost-benefit analyses for such interventions.

Purpose of the Study:

  • To determine the costs associated with implementing a multidisciplinary conference for complication prevention in spinal disorders.
  • To establish a framework for evaluating the financial impact of such conferences.
  • To quantify potential cost savings derived from reduced complications.

Main Methods:

  • Time-driven activity-based costing (TDABC) was used to calculate personnel time and associated wages for conference preparation, presentation, and follow-up.
  • Hourly wage rates from an urban hospital setting were applied to recorded team member time.
  • Published data on complication rates and costs before and after conference implementation were analyzed to determine cost reduction.

Main Results:

  • The annual cost of the conference for 3 spine surgeons and 108 patients was $21,791, with a total time investment of 104.04 minutes per patient.
  • A 51% reduction in 30-day complications was observed, leading to an annual cost saving of $418,518.
  • The multidisciplinary approach resulted in a net potential annual savings of $396,726.

Conclusions:

  • Multidisciplinary conferences, led by spine teams, are essential cost-saving tools for managing complex spinal disorders.
  • TDABC and lean methodology effectively quantify costs and demonstrate potential savings.
  • Resource allocation towards these conferences can improve patient care by reducing complications and healthcare expenditures.