Defining value in spine care.

Spinal disorders are extremely common, debilitating, and costly to the payer and to society as a whole. The rate and cost of various spinal treatments are increasing at an astonishing rate, but it is unclear whether the resulting quality of spinal care is improving. Rather than focusing solely on quality improvement measures or cost-saving measures, there is a recent emphasis on the value of health care. Defining the value of spine care depends on a standardized, accurate method of measuring outcomes and costs. It is important that the outcomes measured are patient centered and that both the outcomes and costs are measured over time with long-term follow-up. The purpose of this article is to review current methods for measuring outcomes and propose a means by which the value of spine care can be more clearly defined.