John Jason, Mirahmadizadeh Alireza, Seifi Ali
School of Medicine, University of Texas Health San Antonio, 7703 Floyd Curl Drive, San Antonio, TX 78229, United States.
Non-Communicable Diseases Research Center, Shiraz University of Medical Sciences, Shiraz, Iran.
J Clin Neurosci. 2018 May;51:80-84. doi: 10.1016/j.jocn.2018.02.013. Epub 2018 Feb 21.
This study examined the distribution of spinal fusion usage among payer groups in the United States.
Using the National Inpatient Sample (NIS) database, total discharges, length of stay, and mean hospital charges of patients who underwent spinal fusion from 1997 to 2014 in the United States were determined and analyzed.
5,715,625 total discharges with spinal fusion were reported. Among them, 2,875,188 (50.3%) were covered by private insurance, 1,710,182 by Medicare (29.9%), 342,638 (6.0%) by Medicaid, and 91,990 (1.6%) were uninsured. A statistically significant increase in spinal fusion usage occurred within each payer group over the study period (P < 0.001). For every year of the study period, private insurance patients had the most number and uninsured patients had the least number of total discharges with spinal fusion. Furthermore, annual growth in spinal fusion usage was greatest among private insurance patients, and smallest among uninsured patients.
Total discharges with spinal fusion increased significantly across all payer groups between 1997 and 2014, but not equally. Further inquiry is indicated to determine the etiology of spinal fusion usage discrepancies between payer groups.
本研究调查了美国各支付方群体中脊柱融合术的使用分布情况。
利用国家住院样本（NIS）数据库，确定并分析了1997年至2014年在美国接受脊柱融合术患者的总出院人数、住院时间和平均住院费用。
报告了5715625例脊柱融合术的总出院人数。其中，2875188例（50.3%）由私人保险支付，1710182例由医疗保险支付（29.9%），342638例由医疗补助支付（6.0%），91990例（1.6%）未参保。在研究期间，每个支付方群体的脊柱融合术使用量均有统计学意义的增加（P < 0.001）。在研究期间的每一年，接受脊柱融合术总出院人数中，私人保险患者最多，未参保患者最少。此外，脊柱融合术使用量的年增长率在私人保险患者中最大，在未参保患者中最小。
1997年至2014年期间，所有支付方群体的脊柱融合术总出院人数均显著增加，但并不均衡。需要进一步调查以确定各支付方群体之间脊柱融合术使用差异的病因。
