对2000年至2014年美国按服务收费的医疗保险人群中硬膜外注射治疗脊柱疼痛的使用模式进行回顾性队列研究。
Retrospective cohort study of usage patterns of epidural injections for spinal pain in the US fee-for-service Medicare population from 2000 to 2014.
作者信息
Manchikanti Laxmaiah, Pampati Vidyasagar, Hirsch Joshua A
机构信息
Pain Management Center of Paducah, Paducah, Kentucky, USA.
Department of Anesthesiology and Perioperative Medicine, University of Louisville, Louisville, Kentucky, USA.
出版信息
BMJ Open. 2016 Dec 13;6(12):e013042. doi: 10.1136/bmjopen-2016-013042.
OBJECTIVE
To assess the usage patterns of epidural injections for chronic spinal pain in the fee-for-service (FFS) Medicare population from 2000 to 2014 in the USA.
DESIGN
A retrospective cohort.
METHODS
The descriptive analysis of the administrative database from Centers for Medicare and Medicaid Services (CMS) Physician/Supplier Procedure Summary (PSPS) master data from 2000 to 2014 was performed. The guidance from Strengthening the Reporting of Observational studies in Epidemiology (STROBE) was applied. Analysis included multiple variables based on the procedures, specialties and geography.
RESULTS
Overall epidural injections increased 99% per 100 000 Medicare beneficiaries with an annual increase of 5% from 2000 to 2014. Lumbar interlaminar and caudal epidural injections constituted 36.2% of all epidural injections, with an overall decrease of 2% and an annual decrease of 0.2% per 100 000 Medicare beneficiaries. However, lumbosacral transforaminal epidural injections increased 609% with an annual increase of 15% from 2000 to 2014 per 100 000 Medicare population.
CONCLUSIONS
Usage of epidural injections increased from 2000 to 2014, with a decline thereafter. However, an escalating growth has been seen for lumbosacral transforaminal epidural injections despite numerous reports of complications and regulations to curb the usage of transforaminal epidural injections.
目的
评估2000年至2014年美国按服务收费（FFS）的医疗保险人群中硬膜外注射用于慢性脊柱疼痛的使用模式。
设计
一项回顾性队列研究。
方法
对医疗保险和医疗补助服务中心（CMS）2000年至2014年医师/供应商程序摘要（PSPS）主数据的行政数据库进行描述性分析。应用了加强流行病学观察性研究报告（STROBE）的指南。分析包括基于程序、专业和地理位置的多个变量。
结果
从2000年到2014年，每10万名医疗保险受益人中硬膜外注射的总体使用率增加了99%，年增长率为5%。腰椎椎间和骶管硬膜外注射占所有硬膜外注射的36.2%，每10万名医疗保险受益人总体下降了2%，年下降率为0.2%。然而，从2000年到2014年，每10万名医疗保险人群中腰骶部经椎间孔硬膜外注射增加了609%，年增长率为15%。
结论
硬膜外注射的使用从2000年到2014年有所增加，此后有所下降。然而，尽管有大量关于并发症的报告以及限制经椎间孔硬膜外注射使用的规定，但腰骶部经椎间孔硬膜外注射的使用仍呈不断上升的趋势。
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