Gerlach Erik B, Richards Alexandra R, Plantz Mark A, Fei-Zhang David J, Hsu Wellington K, Patel Alpesh A
Department of Orthopaedic Surgery, Northwestern Feinberg School of Medicine, Chicago, IL, United States.
Spine Surg Relat Res. 2022 Mar 4;6(5):416-421. doi: 10.22603/ssrr.2021-0267. eCollection 2022 Sep 27.
To summarize the main findings from research on measuring the value in spine surgery.
Determining the value of surgical interventions, which is defined by the quality and efficacy of care received divided by the cost to deliver healthcare, is inherently complex. The two most fundamental components of value-quality and total cost-are multifactorial and difficult to quantify.
A narrative review of all the relevant papers known to the author was conducted.
It is straightforward to calculate the aggregate hospital cost following a surgical procedure, but it is not simple to estimate the total cost of a procedure-including the direct and indirect costs. These individual metrics can help providers make more educated decisions with regards to improving patient quality of life and minimizing unnecessary costs. A consensus of the appropriate cost-per-quality-adjusted life-year threshold of different spine surgeries needs to be established. As these metrics become more commonplace in spine surgery, the potential for personalized health care will continue to be developed.
As the healthcare system shifts toward value-based care, there is a substantial need for research assessing the value as defined by the quality and efficacy of care received divided by the cost to deliver healthcare of specific spine surgery procedures. Studies on different predictors-both patient-specific and surgical-that may influence outcomes, cost, and value are required.
总结脊柱手术价值评估研究的主要发现。
确定手术干预的价值本质上很复杂，其定义为所接受治疗的质量和疗效除以提供医疗服务的成本。价值的两个最基本组成部分——质量和总成本——是多因素的且难以量化。
对作者所知的所有相关论文进行叙述性综述。
计算手术后的医院总费用很简单，但估计一个手术的总成本（包括直接和间接成本）并不容易。这些单独的指标可以帮助医疗服务提供者在改善患者生活质量和尽量减少不必要成本方面做出更明智的决策。需要就不同脊柱手术的适当质量调整生命年成本阈值达成共识。随着这些指标在脊柱手术中变得越来越普遍，个性化医疗的潜力将继续得到开发。
随着医疗系统向基于价值的医疗转变，迫切需要开展研究，评估由所接受治疗的质量和疗效除以特定脊柱手术的医疗服务提供成本所定义的价值。需要对可能影响结果、成本和价值的不同预测因素（包括患者特异性和手术相关因素）进行研究。
