医学
回廊的
医疗成本与利用项目
腰椎
门诊护理
人口
门诊手术
外科
诊断代码
急诊医学
医疗保健
环境卫生
经济
经济增长
作者
Darryl T. Gray,Richard A. Deyo,William Kreuter,Sohail K. Mirza,Patrick J. Heagerty,Bryan A. Comstock,Leighton Chan
出处
期刊:Spine
[Ovid Technologies (Wolters Kluwer)]
日期:2006-08-01
卷期号:31 (17): 1957-1963
被引量:252
标识
DOI:10.1097/01.brs.0000229148.63418.c1
摘要
Sequential cross-sectional study.To quantify patterns of outpatient lumbar spine surgery.Outpatient lumbar spine surgery patterns are undocumented.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.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.While inpatient lumbar surgery rates remained relatively stable for 1994 to 2000, outpatient surgery increased over time.
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