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Monthly multidisciplinary complex spine conference: a cost-analysis utilizing time-driven activity-based costing

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Abstract

Purpose

To understand costs and provide an initial framework associated with conference implementation as it pertains to complication prevention.

Methods

Team members' time spent on conference preparation, presentation, and follow-up tasks was recorded and averaged to determine the time required to prepare and present one patient. Using 2022 hourly wage rates based on our urban hospital setting, wage values were calculated for each personnel type and applied to their time spent. The total cost of the conference was annualized and calculated from the time spent in the three phases of the conference multiplied by the wage rate. Published data on complication rates and associated costs before and after conference implementation were used to calculate total cost reduction.

Results

With 3 active spine surgeons and 108 patients per year, the total time investment was 104.04 min per patient, costing $21,791 annually. Total RN equivalent value per patient was 5.25 for all three phases. Using a historical model, this multidisciplinary approach for adult spinal deformity reduced complications by 51% at 30 days, resulting in cost savings of $418,518 per year. Thus, the model demonstrates that implementation of this approach resulted in a potential total savings of $396,726/year.

Conclusion

Implementing a cost-saving tool for managing complex spinal disorders is a responsibility of the spine team, who should lead a multidisciplinary conference. The combination of TDABC and lean methodology can effectively demonstrate the variable costs associated with this multidisciplinary effort and models provide evidence of potential cost-savings when applied to a multidisciplinary adult spinal deformity conference. These findings should encourage clinicians and administrators to allocate resources to improve patient care by reducing complications and costs.

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Funding

No funding was received for conducting this study.

Author information

Authors and Affiliations

  1. Department of Neurosurgery, Center for Neuroscience and Spine, Virginia Mason Medical Center, Seattle, WA, USA

    Rajiv Sethi, Philip Louie, Aiyush Bansal, Michelle Gilbert, Venu Nemani, Jean-Christophe Leveque, Caroline E. Drolet, Brooks Ohlson, Richard Kronfol, Joseph Strunk, Kelly Cornett-Gomes, Andrew Friedman & Devon LeFever

  2. Schools of Medicine and Public Health, University of Washington, Seattle, WA, USA

    Rajiv Sethi

  3. Division of Health Economics, Radboud University Medical Center, Nijmegen, Netherlands

    Rajiv Sethi

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  1. Rajiv Sethi
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Contributions

RS: conceptualization, methodology, validation, writing—review and editing, supervision, and project administration. PL: conceptualization, investigation, and writing—review and editing. AB: conceptualization, visualization, and writing—reviewing and editing. MG: conceptualization, investigation, and writing—reviewing and editing. VN: conceptualization, investigation, and writing—reviewing and editing. J-CL: conceptualization, investigation, and writing—reviewing and editing. CED: conceptualization, formal analysis, software, and data curation. BO: conceptualization, investigation, and writing—reviewing and editing. RK: conceptualization, investigation, and writing—reviewing and editing. JS: conceptualization, investigation, and writing—reviewing and editing. KC-G: conceptualization, investigation, and writing—reviewing and editing. AF: conceptualization, investigation, and writing—reviewing and editing. DF: conceptualization, writing—original draft, review and editing, visualization, and validation.

Corresponding author

Correspondence to Rajiv Sethi.

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Conflict of interest

Financial interests: Rajiv Sethi is a paid consultant for Alphatec Spine, Medtronic, Mighty Oak Medical, Nuvasive, Stryker, and Surgalign. Rajiv Sethi receives royalties from Medicrea and Orthofix. Jean-Christophe Leveque received paid support as a presenter from Nuvasive. Philip Louie has received funding from Alphatec Spine, Surgalign, and Viseon. Non-financial interests: Rajiv Sethi has served on advisory boards for Journal of Spine Deformity, Scoliosis Research Society, Spine Safety Foundation, and Washington State Orthopaedic Association. Rajiv Sethi is a fellow of the American Academy of Orthopaedic Surgeons. Jean-Christophe Leveque is on the advisory board for the Scoliosis Research Society. Philip Louie is on the advisory board for AO Spine.

Ethical approval

The current study was approved by our institutional review board as a Quality Improvement Publication (QUIP) project.

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Sethi, R., Louie, P., Bansal, A. et al. Monthly multidisciplinary complex spine conference: a cost-analysis utilizing time-driven activity-based costing. Spine Deform 12, 433–442 (2024). https://doi.org/10.1007/s43390-023-00798-4

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  • DOI: https://doi.org/10.1007/s43390-023-00798-4

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