The Impact of Outpatient Physical Therapy on Patient-Reported Outcomes After Lumbar Fusion: Perspective from A Bundled Care Dataset.
Publication/Presentation Date
9-1-2024
Abstract
OBJECTIVE/BACKGROUND: As value-based care grows in popularity across the United States, more payers have turned toward bundled payment models for surgical procedures. Though episode costs in spine are highly variable, physical therapy (PT) has been identified as a driver of 90-day cost. The goal of this study is to assess the impact of postoperative PT on patient-reported outcomes and cost after lumbar fusion surgery using bundled insurance data.
METHODS: Bundled payment information of lumbar fusion episodes-of-care (EOC) from 2019 to 2021 was reviewed at a single, urban, tertiary care center. EOC comprised a 210-day period surrounding the date of the procedure, beginning 30 days preoperatively and ending 180 days postoperatively. Patients were grouped into physical therapy (PT) and no physical therapy (no PT) groups based on the presence of PT claims.
RESULTS: Bivariate analysis of surgical outcomes revealed similar overall complication rates (P = 0.413), 30-day readmissions (P = 0.366), and 90-day readmissions (P = 0.774). Patients who did not participate in postoperative PT had significantly better preoperative physical component score (PCS) (P = 0.003), 6-month postoperative PCS (P = 0.001), and 6-month ΔPCS (P = 0.026) compared with patients who participated in postoperative PT. At 1-year follow-up, patients who did not participate in PT had less leg pain (P = 0.041) than those who did participate in PT.
CONCLUSIONS: Our study finds that PT after lumbar fusion is not associated with significant improvement in Oswestry Disability Index, PCS, mental component score, or visual analog scale pain scores. Additionally, the number of PT sessions a patient attends has no correlation with improvement in these outcomes.
Volume
189
First Page
211
Last Page
211
ISSN
1878-8769
Published In/Presented At
McCurdy, M. A., Narayanan, R., Trenchfield, D., Lee, Y., Khanna, A., Ebrahimi, M., Kurd, M., Kaye, I. D., Canseco, J. A., Hilibrand, A. S., Vaccaro, A. R., Schroeder, G. D., & Kepler, C. (2024). The Impact of Outpatient Physical Therapy on Patient-Reported Outcomes After Lumbar Fusion: Perspective from A Bundled Care Dataset. World neurosurgery, 189, e211–e218. https://doi.org/10.1016/j.wneu.2024.06.020
Disciplines
Business Administration, Management, and Operations | Health and Medical Administration | Management Sciences and Quantitative Methods
PubMedID
38866235
Department(s)
Administration and Leadership
Document Type
Article