Shifting spine interventional procedures from the hospital to a clinic setting: Increased efficiency and decreased health system costs.

From the 2021 HVPAA National Conference

Justin Costello (University of Utah), Miriam Peckham, Yoshimi Anzai, Lubdha Shah, Geoff de Gennaro, Troy Hutchins

Background

Spine interventional procedures are commonly performed for the diagnosis and treatment of pain and have dramatically increased in volume in the past three decades. At our institution, high referral volumes necessitated using both a hospital-based interventional suite, and a clinic-based suite scheduled on a first come basis.

Objective

We sought to determine whether the clinic-based suite provided benefits in efficiency and health system cost in comparison to the hospital suite without compromising quality of care.

Methods

To investigate differences between outpatient procedures performed in hospital-based (HBPR) and clinic-based (CBPR) procedure rooms, we reviewed all consecutive outpatient spine interventional pain procedures performed by the interventional neuroradiology service over a 12-month period. We analyzed procedure complexity, associated fluoroscopic times, procedural times, patient wait times, and health system costs for each case, as well as any complications.

Results

Our analysis demonstrated similar procedural complexity between sites with decreased average fluoroscopic time (112 seconds vs. 163 seconds, p=0.002), procedural time (17 minutes vs. 28 minutes, p<0.001), and wait time (20 minutes vs. 38 minutes, p<0.001) in the CBPR versus the HBPR. In addition, there were no complications at either site.

Conclusions

The analysis of cost to the health system demonstrated that procedures in the HBPR cost >14 times the amount to perform than in the CBPR.

Clinical Implications

Performing spine interventional pain procedures in a clinic-based procedure room adds value by decreasing wait times, procedural, fluoroscopic, and health system costs compared to a hospital-based procedure room without compromising safety.