Background:

Private insurers utilize the calendar deductible system, placing pressure on patients and medical personnel to perform medical services before the end of the year to maximize patient savings. The impact the deductible calendar has on patient-reported outcomes (PROs) following spine surgery is poorly understood. The objective of our study was to investigate if patients undergoing surgery in December had different PROs and demographics compared to all other months.

Methods:

The Quality Outcome Database, a national spine registry, was queried for patients who underwent elective spine surgery between January 2012 to January 2021 for degenerative spine conditions. PROs and demographics were compared between the December and non-December groups using various statistical tests.

Results:

978 patients (9.3%) underwent ACDF in December vs. 10,526 (90.7%) in other months. There was a significantly higher percentage of patients in December who had private insurance and were employed. 1,104 patients (8.5%) underwent lumbar fusion in December vs. 11,826 (91.5%) in other months. There was a greater chance of undergoing surgery in December if patients had private insurance and were employed. While some PROs were statistically significant for the lumbar and cervical cohorts between December and non-December patients, none were clinically significant.

Conclusion:

Patients undergoing elective spine surgery in December were more likely to have private insurance and be employed. PROs for ACDF and lumbar fusions were not affected by surgical timing (December yes/no). Other spinal procedures directed at more chronic diseases might be more susceptible to external influence of insurance deductibles.