AUTHOR=Fu Zhongmin , Xie Yan , Li Peifang , Gao Menghui , Chen Jiali , Ning Ning 

TITLE=Assessing multidisciplinary follow-up pattern efficiency and cost in follow-up care for patients in cervical spondylosis surgery: a non-randomized controlled study

JOURNAL=Frontiers in Medicine

VOLUME=11

YEAR=2024

URL=https://www.frontiersin.org/journals/medicine/articles/10.3389/fmed.2024.1354483

DOI=10.3389/fmed.2024.1354483

ISSN=2296-858X

ABSTRACT=<sec id="sec1"><title>Background</title><p>The use of multidisciplinary treatment programs in out-of-hospital healthcare is a new area of research. Little is known about the benefits of this method in the management of discharged patients undergoing cervical spondylosis surgery.</p></sec><sec id="sec2"><title>Objective</title><p>This study aimed to explore the effect of a contracted-based, multidisciplinary follow-up plan in patients after cervical spondylosis surgery.</p></sec><sec id="sec3"><title>Methods</title><p>This non-blinded non-randomized controlled study was conducted with 88 patients (44 in the intervention group, 44 in the control group). The clinical outcomes, including Neck Disability Index (NDI), pain score (VAS), Self-Efficacy for Managing Chronic Disease 6-item Scale (SECD-6), and 12-Item Short-Form Health Survey (SF-12) score were assessed at the time of discharge, 24–72 h, 1 month, and 3 months post-discharge. The complications, patient satisfaction, and economic indicators were assessed at the final follow-up (3 months).</p></sec><sec id="sec4"><title>Results</title><p>Patients who received contracted follow-up showed greater improvement in neck dysfunction at 24–72 h, 1 month, and 3 months after discharge compared to those who received routine follow-up (<italic>p</italic> &lt; 0.001). At 1 month after discharge, the intervention group exhibited better self-efficacy (<italic>p</italic> = 0.001) and quality of life (<italic>p</italic> &lt; 0.001) than the control group, and these improvements lasted for 3 months. The intervention group reported lower pain scores at 24–72 h and 1 month (<italic>p</italic> = 0.008; <italic>p</italic> = 0.026) compared to the control group. The incidence of complications was significantly lower in the intervention group (11.4%) compared to the control group (40.9%). The total satisfaction score was significant difference between the two groups (<italic>p</italic> &lt; 0.001). Additionally, the intervention group had lower direct medical costs (<italic>p</italic> &lt; 0.001), direct non-medical costs (<italic>p</italic> = 0.035), and total costs (<italic>p</italic> = 0.04) compared to the control group. However, there was no statistically significant difference in indirect costs between the two groups (<italic>p</italic> = 0.59).</p></sec><sec id="sec5"><title>Conclusion</title><p>A multidisciplinary contract follow-up plan has significant advantages regarding neck disability, self-efficacy, quality of life, postoperative complications, patient satisfaction, and direct costs compared with routine follow-up.</p></sec>