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Disparities in Rates of Fusions in Lumbar Disc Pathologies

STUDY DESIGN: Retrospective cohort study. OBJECTIVE: To identify disparities in surgical decision making for lumbar disc pathologies based on patient demographics, hospital characteristics, and temporal characteristics of admission. METHODS: A retrospective analysis of patients admitted for surgical...

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Autores principales: Kim, Soobin, Ryoo, James S., Ostrov, Philip B., Reddy, Abhinav K., Behbahani, Mandana, Mehta, Ankit I.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: SAGE Publications 2020
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8907631/
https://www.ncbi.nlm.nih.gov/pubmed/32935583
http://dx.doi.org/10.1177/2192568220951137
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author Kim, Soobin
Ryoo, James S.
Ostrov, Philip B.
Reddy, Abhinav K.
Behbahani, Mandana
Mehta, Ankit I.
author_facet Kim, Soobin
Ryoo, James S.
Ostrov, Philip B.
Reddy, Abhinav K.
Behbahani, Mandana
Mehta, Ankit I.
author_sort Kim, Soobin
collection PubMed
description STUDY DESIGN: Retrospective cohort study. OBJECTIVE: To identify disparities in surgical decision making for lumbar disc pathologies based on patient demographics, hospital characteristics, and temporal characteristics of admission. METHODS: A retrospective analysis of patients admitted for surgical intervention of disc herniation or degeneration was performed to observe the effect of demographic, hospital, and admission-related factors on the decision to perform an isolated decompression or decompression with single level fusion using the National Inpatient Sample. RESULTS: Of 84 953 patients with lumbar disc pathologies, 69 975 patients were treated electively, and 14 978 patients were treated nonelectively. Hispanic and Asian/Pacific Islander patients were less likely to receive a fusion for elective cases compared with White patients (odds ratio [OR] 0.88, P = .004; OR 0.70, P < .001, respectively). In elective cases, privately insured and self-paying patients were less likely to receive a fusion compared with Medicare patients (OR 0.83, P < .001; OR 0.66, P < .001, respectively), while this effect was limited to self-pay patients in nonelective cases (OR 0.44, P < .001). Urban teaching and nonteaching hospitals were less likely to perform fusions compared with rural hospitals in nonelective cases (OR 0.47, P < .001; OR 0.58, P < .001, respectively). Private for-profit hospitals were associated with higher rates of fusion in both elective and nonelective cases (OR 1.16, P = .003; OR 1.94, P < .001). CONCLUSION: This study illustrates disparities in the modality of surgical intervention for lumbar disc pathologies in terms of demographics, hospital characteristics, and temporal characteristics of admission. The development of more evidence-based guidelines is warranted to reduce variability seen in treatment regimens for these conditions.
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spelling pubmed-89076312022-03-11 Disparities in Rates of Fusions in Lumbar Disc Pathologies Kim, Soobin Ryoo, James S. Ostrov, Philip B. Reddy, Abhinav K. Behbahani, Mandana Mehta, Ankit I. Global Spine J Original Articles STUDY DESIGN: Retrospective cohort study. OBJECTIVE: To identify disparities in surgical decision making for lumbar disc pathologies based on patient demographics, hospital characteristics, and temporal characteristics of admission. METHODS: A retrospective analysis of patients admitted for surgical intervention of disc herniation or degeneration was performed to observe the effect of demographic, hospital, and admission-related factors on the decision to perform an isolated decompression or decompression with single level fusion using the National Inpatient Sample. RESULTS: Of 84 953 patients with lumbar disc pathologies, 69 975 patients were treated electively, and 14 978 patients were treated nonelectively. Hispanic and Asian/Pacific Islander patients were less likely to receive a fusion for elective cases compared with White patients (odds ratio [OR] 0.88, P = .004; OR 0.70, P < .001, respectively). In elective cases, privately insured and self-paying patients were less likely to receive a fusion compared with Medicare patients (OR 0.83, P < .001; OR 0.66, P < .001, respectively), while this effect was limited to self-pay patients in nonelective cases (OR 0.44, P < .001). Urban teaching and nonteaching hospitals were less likely to perform fusions compared with rural hospitals in nonelective cases (OR 0.47, P < .001; OR 0.58, P < .001, respectively). Private for-profit hospitals were associated with higher rates of fusion in both elective and nonelective cases (OR 1.16, P = .003; OR 1.94, P < .001). CONCLUSION: This study illustrates disparities in the modality of surgical intervention for lumbar disc pathologies in terms of demographics, hospital characteristics, and temporal characteristics of admission. The development of more evidence-based guidelines is warranted to reduce variability seen in treatment regimens for these conditions. SAGE Publications 2020-09-16 2022-03 /pmc/articles/PMC8907631/ /pubmed/32935583 http://dx.doi.org/10.1177/2192568220951137 Text en © The Author(s) 2020 https://creativecommons.org/licenses/by-nc-nd/4.0/This article is distributed under the terms of the Creative Commons Attribution-NonCommercial-NoDerivs 4.0 License (https://creativecommons.org/licenses/by-nc-nd/4.0/) which permits non-commercial use, reproduction and distribution of the work as published without adaptation or alteration, without further permission provided the original work is attributed as specified on the SAGE and Open Access pages (https://us.sagepub.com/en-us/nam/open-access-at-sage).
spellingShingle Original Articles
Kim, Soobin
Ryoo, James S.
Ostrov, Philip B.
Reddy, Abhinav K.
Behbahani, Mandana
Mehta, Ankit I.
Disparities in Rates of Fusions in Lumbar Disc Pathologies
title Disparities in Rates of Fusions in Lumbar Disc Pathologies
title_full Disparities in Rates of Fusions in Lumbar Disc Pathologies
title_fullStr Disparities in Rates of Fusions in Lumbar Disc Pathologies
title_full_unstemmed Disparities in Rates of Fusions in Lumbar Disc Pathologies
title_short Disparities in Rates of Fusions in Lumbar Disc Pathologies
title_sort disparities in rates of fusions in lumbar disc pathologies
topic Original Articles
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8907631/
https://www.ncbi.nlm.nih.gov/pubmed/32935583
http://dx.doi.org/10.1177/2192568220951137
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