Presurgical biopsychosocial variables predict medical and compensation costs of lumbar fusion in Utah workers' compensation patients

Abstract

Background context Elective lumbar fusion surgery is a prevalent and costly procedure that requires a lengthy rehabilitation. It is important to identify presurgical biopsychosocial predictors of medical and compensation costs in such patients. Purpose To determine if presurgical biopsychosocial variables are predictive of compensation and medical costs in a cohort of Utah lumbar fusion patients receiving workers' compensation. Study design/setting A retrospective-cohort study consisting of a review of presurgical medical records and accrued medical and compensations costs. Patient sample A consecutive sample of 203 compensated workers from Utah who underwent lumbar fusion from 1990 to 1995. Patients were at least 2 years postsurgery. Outcome measures Total accrued medical and compensations costs. Methods A retrospective review of presurgical biopsychosocial variables and total accrued medical and compensation costs was conducted. Results Presurgical variables from each of the biopsychosocial domains were statistically significantly correlated with medical and compensation costs. Social and biological variables were the best predictors of total compensation costs, whereas psychological variables were better predictors of total medical costs. Conclusions Compensation and medical costs associated with posterolateral lumbar fusion can be predicted by preintervention biopsychosocial variables. Cost reduction programs might benefit from identifying biopsychosocial factors related to increased costs.