The Spine Journal published an article comparing posterior lumbar fusion outcomes at physician-owned hospitals to non-physician owned hospitals.
The researchers assessed 90-day costs and outcomes for the patients, who underwent one- to three-level fusions in either physician-owned or non-physician-owned hospitals. The Affordable Care Act placed a moratorium on new POHs and restrictions on existing POHs to keep them from expanding.
The researchers gathered data from 6,679 patients undergoing the elective spinal fusions. The majority of the procedures, 97.1 percent, were preformed at non-physician-owned hospitals. Researchers found:
1. Patients undergoing fusion at physician-owned hospitals had lower odds of thromboembolic complications than at non-physician-owned hospitals after controlling for patient and hospital demographic factors.
2. POHs were also associated with $10,218 lower risk-adjusted inpatient charges and $2,302 lower inpatient costs. The 90-day charges were also $9,780 lower and 90-day costs were $2,324 lower at POHs.
3. There wasn't significant difference between the two settings for cardiac complications, pulmonary complications, wound complications or septic complications.
4. The postoperative ED visits, revision surgery rates and readmission rates were similar in both the POHs and non-POHs.
5. Study authors called for a revaluation of the ACA restrictions on expanding POHs.