Comparison of 2 Models of Care for Children With Medical Complexity Following Spinal Fusion

Clin Pediatr (Phila). 2024 Nov;63(11):1537-1543. doi: 10.1177/00099228241228104. Epub 2024 Jan 30.

Abstract

We conducted a retrospective chart review of patients with neuromuscular scoliosis following spinal fusion surgery who were cared for post-operatively by either a hospitalist/orthopedics co-management team or a complex care clinic (CCC). Assignment to either treatment group was not random. To account for baseline differences between groups, we calculated propensity scores and used these as probability weights in generalized linear models. After matching, the CCC had a shorter length of stay (LOS, coefficient = -2.60; P = .04) without a significant difference in 30-day readmission rate (P = .62). For secondary outcomes, there were some significant resource utilization benefits favoring the complex care group without significant difference in complication outcomes between groups. In managing patients after spinal fusion surgery, both groups had similar LOS compared with prior studies of children after spinal fusion surgery. Management by the CCC may confer some outcome benefits for their patients.

Keywords: cerebral palsy; co-management; medical complexity; neuromuscular scoliosis; spinal fusion surgery.

Publication types

  • Comparative Study

MeSH terms

  • Adolescent
  • Child
  • Female
  • Humans
  • Length of Stay* / statistics & numerical data
  • Male
  • Patient Care Team
  • Patient Readmission / statistics & numerical data
  • Postoperative Care / methods
  • Postoperative Complications / therapy
  • Propensity Score
  • Retrospective Studies
  • Scoliosis* / surgery
  • Spinal Fusion* / methods
  • Treatment Outcome