Pain Management Center of Paducah, 2831 Lone Oak Road, Paducah, KY, 42003, USA.
BMC Health Serv Res. 2010 Mar 30;10:84. doi: 10.1186/1472-6963-10-84.
The Office of Inspector General of the Department of Health and Human Services (OIG-DHHS) issued a report which showed explosive growth and also raised questions of lack of medical necessity and/or indications for facet joint injection services in 2006.The purpose of the study was to determine trends of frequency and cost of facet joint interventions in managing spinal pain.
This analysis was performed to determine trends of frequency and cost of facet jointInterventions in managing spinal pain, utilizing the annual 5% national sample of the Centers forMedicare and Medicaid Services (CMS) for 1997, 2002, and 2006.Outcome measures included overall characteristics of Medicare beneficiaries receiving facet joint interventions, utilization of facet joint interventions by place of service, by specialty, reimbursement characteristics, and other variables.
From 1997 to 2006, the number of patients receiving facet joint interventions per 100,000Medicare population increased 386%, facet joint visits increased 446%, and facet joint interventions increased 543%. The increases were higher in patients aged less than 65 years compared to those 65 or older with patients increasing 504% vs. 355%, visits increasing 587% vs. 404%, and services increasing 683% vs. 498%.Total expenditures for facet joint interventions in the Medicare population increased from over $229 million in 2002 to over $511 million in 2006, with an overall increase of 123%. In 2006, there was a 26.8-fold difference in utilization of facet joint intervention services in Florida compared to the state with the lowest utilization - Hawaii.There was an annual increase of 277.3% in the utilization of facet joint interventions by general physicians, whereas a 99.5% annual increase was seen for nurse practitioners (NPs) and certified registered nurse anesthetists (CRNAs) from 2002 to 2006. Further, in Florida, 47% of facet joint interventions were performed by general physicians.
The reported explosive growth of facet joint interventions in managing spinal pain in certain regions and by certain specialties may result in increased regulations and scrutiny with reduced access.
美国卫生与公众服务部监察长办公室（OIG-DHHS）发布了一份报告，该报告显示 2006 年关节突关节注射服务的数量呈爆炸式增长，同时也引发了对其缺乏医学必要性和/或适应证的质疑。本研究的目的是确定管理脊柱疼痛的关节突关节介入治疗的频率和费用趋势。
本分析旨在确定管理脊柱疼痛的关节突关节介入治疗的频率和费用趋势，利用医疗保险和医疗补助服务中心（CMS）的全国每年 5%的样本，对 1997 年、2002 年和 2006 年的数据进行分析。结果指标包括接受关节突关节介入治疗的医疗保险受益人的总体特征、按服务地点、专业、报销特征和其他变量使用关节突关节介入治疗的情况。
1997 年至 2006 年，每 10 万 Medicare 人群中接受关节突关节介入治疗的患者人数增加了 386%，关节突关节就诊次数增加了 446%，关节突关节介入治疗次数增加了 543%。与 65 岁及以上的患者相比，65 岁以下患者的增幅更高，患者增加了 504%，就诊次数增加了 587%，治疗次数增加了 683%。医疗保险人群中关节突关节介入治疗的总支出从 2002 年的 2.29 多亿美元增加到 2006 年的 5.11 多亿美元，总体增长 123%。2006 年，佛罗里达州关节突关节介入服务的利用率与利用率最低的夏威夷州相差 26.8 倍。2002 年至 2006 年，普通医生使用关节突关节介入治疗的年增长率为 277.3%，而执业护士（NP）和注册麻醉师（CRNA）的年增长率为 99.5%。此外，在佛罗里达州，47%的关节突关节介入治疗由普通医生进行。
某些地区和特定专业治疗脊柱疼痛的关节突关节介入治疗呈爆炸式增长，这可能导致增加监管和审查，同时减少治疗机会。
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