ABSTRACT
STUDY DESIGN: Topic review. OBJECTIVE: Describe value measurement in spine care and discuss the motivation for, methods for, and limitations of such measurement. SUMMARY OF BACKGROUND DATA: Spinal disorders are common and are an important cause of pain and disability. Numerous complementary and competing treatment strategies are used to treat spinal disorders, and the costs of these treatments is substantial and continue to rise despite clear evidence of improved health status as a result of these expenditures. METHODS: The authors present the economic and legislative imperatives forcing the assessment of value in spine care. The definition of value in health care and methods to measure value specifically in spine care are presented. Limitations to the utility of value judgments and caveats to their use are presented. RESULTS: Examples of value calculations in spine care are presented and critiqued. Methods to improve and broaden the measurement of value across spine care are suggested, and the role of prospective registries in measuring value is discussed. CONCLUSION: Value can be measured in spine care through the use of appropriate economic measures and patient-reported outcomes measures. Value must be interpreted in light of the perspective of the assessor, the duration of the assessment period, the degree of appropriate risk stratification, and the relative value of treatment alternatives.
Subject(s)
Health Care Costs , Quality of Health Care/economics , Spinal Cord Diseases/economics , Spinal Diseases/economics , Cost-Benefit Analysis , Decision Making , Health Care Costs/legislation & jurisprudence , Health Care Reform , Humans , Patient Preference , Patient Protection and Affordable Care Act , Quality-Adjusted Life Years , Spinal Cord Diseases/therapy , Spinal Diseases/therapy , United StatesABSTRACT
In an effort to rein in spending and improve patient outcomes, the US government and the private sector have adopted a number of policies over the last decade that hold health care professionals increasingly accountable for the cost and quality of the care they provide. A major driver of these efforts is the Patient Protection and Affordable Care Act of 2010 (ACA or Pub.L. 111-148), which aims to change the US health care system from one that rewards quantity to one that rewards better value through the use of performance measurement. However, for this strategy to succeed in raising the bar on quality and efficiency, it will require the development of more standardized and accurate methods of data collection and further streamlined federal regulations that encourage enhanced patient-centered care instead of creating additional burdens that interfere with the physician-patient relationship.
