Inge S Klatte, Manon Bloemen, Annemieke de Groot, Tina C Mantel, Marjolijn Ketelaar, Ellen Gerrits
Collaborative working in speech and language therapy for children with DLD-What are parents' needs?
International journal of language & communication disorders
substantial heterogeneity number screws used per level fused adolescent idiopathic scoliosis ais surgery assuming equivalent clinical outcomes potential cost savings using fewer pedicle screws estimated using medical decision model sensitivity analysis descriptive analyses explored annual costs 5710 ais inpatient stays using discharge data 2009 kids inpatient database healthcare cost utilization project agency healthcare research quality national allpayer inpatient database patients 10 17 years age identified using icd9cm code idiopathic scoliosis 73730 inpatient stays assumed represent 10level fusions pedicle screws ais high screw density defined 18 screws per level fused standard screw density defined 148 screws per level fused surgical return screw malposition set 23762 sensitivity analysis performed varying cost per screw 6001000 rate surgical revisions screw malposition 01170483 screws 0843 patients reported outcomes include estimated prevented malpositioned screws set 51 averted revision surgeries annual cost savings 2009 us dollars assuming similar clinical outcomes rates complications revision using standard versus highdensity pattern total annual costs 5710 ais hospital stays 278 million 48900 per patient substituting high standard screw density yields 32 fewer screws implanted per patient 932 malpositioned screws prevented 21 88 revision surgeries implant malposition averted potential annual cost savings 11 million 20 million 47 reduction total cost ais hospitalizations reducing number screws used scoliosis surgery could potentially decrease national ais hospitalization costs 7 may improve safety efficiency care however screw construct must first proven safe effective