The Economic Process Behind Surgical Innovation
Changes in Coding and Compensation Correlate with Increased Minimally Invasive Sacroiliac Joint Fusion in the National Surgical Quality Improvement Program (NSQIP) Database
DOI:
https://doi.org/10.55576/job.v2i4.24Keywords:
Sacroiliac joint, Arthrodesis, Fusion, Minimally invasive, NSQIPAbstract
Objective: To analyze trends in open and minimally invasive (MIS) sacroiliac joint fusion (SIJF) that coincide with changes in compensation models and Current Procedural Terminology (CPT) codes.
Design: Database analysis
Setting: American College of Surgeons (ACS) National Surgical Quality Improvement Program (NSQIP) Database
Patients/Participants: Underwent SIJF, based on CPT codes, from 2007-2018
Intervention: Open and MIS SIJF
Main Outcome Measurements: Proportion of open versus MISJ SIJF, proportion of inpatient vs outpatient SIJF, relative value units
Results: There were 744 total SIJFs performed. Open SIJFs totaled 683, while 65 MIS SIJFs were performed. The number of SIJFs increased yearly, apart from two years, with a similar trend noted when controlling for the number of NSQIP entries per year. From 2014-2018, MIS SIJF made up a significantly larger proportion of total SIJFs (p<0.0001) and the proportion of outpatient SIJFs increased over the entire study period (p=0.0002).
Conclusions: SIJF is being increasingly utilized, coinciding with regulatory approval and the American Medical Association’s formal recognition of MIS SIJF. Related changes to coding and compensation serve as a model for the economic processes behind surgical innovation, highlighting the importance of surgeon advocacy along the way.
Level of Evidence: III; Retrospective Cohort Study
Keywords: Sacroiliac joint; arthrodesis; fusion; minimally invasive; NSQIP, economics, compensation, policy
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