Population-based trends in volumes and rates of ambulatory lumbar spine surgery

被引:238
作者
Gray, Darryl T.
Deyo, Richard A.
Kreuter, William
Mirza, Sohail K.
Heagerty, Patrick J.
Comstock, Bryan A.
Chan, Leighton
机构
[1] Agcy Healthcare Res & Qual, Ctr Qual Improvement & Patient Safety, Rockville, MD 20850 USA
[2] Univ Washington, Ctr Cost & Outcomes Res, Dept Hlth Serv, Seattle, WA 98195 USA
[3] Univ Washington, Ctr Cost & Outcomes Res, Dept Med, Seattle, WA 98195 USA
[4] Univ Washington, Ctr Cost & Outcomes Res, Dept Orthopaed & Sports Med, Seattle, WA 98195 USA
[5] Univ Washington, Ctr Cost & Outcomes Res, Dept Biostat, Seattle, WA 98195 USA
[6] Univ Washington, Ctr Cost & Outcomes Res, Dept Rehabil, Seattle, WA 98195 USA
关键词
lumbar spine surgery; rate trends; ambulatory surgery; outpatient surgery; discectomy; fusion; Nationwide Inpatient Sample (NIS); State Inpatient Database (SID); State Ambulatory Surgery Database (SASD); Healthcare Cost and Utilization Project (HCUP); National Hospital Discharge Survey (NHDS); National Survey of Ambulatory Surgery (NSAS);
D O I
10.1097/01.brs.0000229148.63418.c1
中图分类号
R74 [神经病学与精神病学];
学科分类号
摘要
Study Design. Sequential cross-sectional study. Objectives. To quantify patterns of outpatient lumbar spine surgery. Summary of Background Data. Outpatient lumbar spine surgery patterns are undocumented. Methods. We used CPT-4 and ICD-9-CM diagnosis/procedure codes to identify lumbar spine operations in 20 + year olds. We combined sample volume estimates from the National Hospital Discharge Survey (NHDS), the National Survey of Ambulatory Surgery (NSAS), and the Healthcare Cost and Utilization Project (HCUP) Nationwide Inpatient Sample (NIS) with complete case counts from HCUP's State Inpatient Databases (SIDs) and State Ambulatory Surgery Databases (SASDs) for four geographically diverse states. We excluded pregnant patients and those with vertebral fractures, cancer, trauma, or infection. We calculated age- and sex-adjusted rates. Results. Ambulatory cases comprised 4% to 13% of procedures performed from 1994 to 1996 (NHDS/NSAS data), versus 9% to 17% for 1997 to 2000 (SID/SASD data). Discectomies comprised 70% to 90% of outpatient cases. Conversely, proportions of discectomies performed on outpatients rose from 4% in 1994 to 26% in 2000. Outpatient fusions and laminectomies were uncommon. NIS data indicate that nationwide inpatient surgery rates were stable ( 159 cases/100,000 in 1994 vs. 162/100,000 in 2000). However, combined data from all sources suggest that inpatient and outpatient rates rose from 164 cases/100,000 in 1994 to 201/100,000 in 2000. Conclusions. While inpatient lumbar surgery rates remained relatively stable for 1994 to 2000, outpatient surgery increased over time.
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页码:1957 / 1963
页数:7
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