Outpatient Surgery Magazine, providing current information on Surgical Services, Surgical Facility Administration, Outpatient Surgery News and Trends, OR Excellence and more.
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5 8 O U T P AT I E N T S U R G E R Y M A G A Z I N E O N L I N E | A P R I L 2 0 1 4 do extremely well. Outpatient isn't ideal for every patient, of course. Studies suggest that those requiring fusion on more than 2 levels are better treated in hospitals, as are those with severe spinal cord compression, compli- cated deformities, or multiple co-morbidities such as obesity and heart disease, in order to ensure observation and access to immediate multi-specialty critical care if it becomes necessary. One hurdle to building an outpatient spinal fusion service line is economic. Medicare doesn't list an outpatient code for the procedure, and many commercial insurers don't cover it. But as we continue to produce high-quality outcomes and satisfied patients, and as carriers take note that outpatient fusion can be done at a fraction of the cost of hospital surgery (possibly representing millions of dollars in health- care cost savings), that will be a large incentive for federal and private insurers to change their tune. Economics will carry the day. 3. Outstanding outcomes We've been doing same-day spinal fusion since 2006, with excellent outcomes. We're done within one-half or even one-fourth of the time it would take us in a large hospital setting. And since our patients are able to mobilize reasonably quickly after the procedure — they're sit- ting in a chair, walking, urinating and tolerating nutrition within a cou- ple of hours, supported by nothing more than oral pain medications — we can discharge them after an 8-hour, or at the most a 23-hour, recovery to convalesce at home. We've seen few complications, and our patients return to normal activity in a comparatively short 4 to 6 weeks. The true sign of success? Patients satisfied with their out- comes have been telling others about us and our work, and encourag- ing them to go outpatient, too. S P I N E S U R G E R Y OSE_1404_part2_Layout 1 4/4/14 2:39 PM Page 58