佛罗里达州和纽约州工人赔偿案例中的腰椎间盘切除术和再次手术：治疗趋势是否与其他支付类型相似？
Lumbar Discectomy and Reoperation Among Workers' Compensation Cases in Florida and New York: Are Treatment Trends Similar to Other Payer Types?
机构信息
Department of Surgery (Dr Ammerman, Dr Wind); Department of Neurological Surgery, George Washington University Hospital (Dr Wind); Department of Orthopedic Surgery (Dr Goldsmith), Sibley Memorial Hospital, Washington DC; and Telos Partners, LLC, Denver, Colorado (Dr Inzana).
出版信息
J Occup Environ Med. 2020 Sep;62(9):e478-e484. doi: 10.1097/JOM.0000000000001943.
OBJECTIVE
The aim of this study was to better understand current treatment trends and revision rates for lumbar disc herniation (LDH) in the workers' compensation (WC) population compared with other payer types.
METHODS
This was a retrospective analysis of outpatient claims data from Florida and New York during 2014 to 2016.
RESULTS
WC patients were less likely to undergo discectomy in Florida (15% vs 19%; P < 0.001) and New York (10% vs 15%; P < 0.001). The odds of WC patients undergoing revision discectomy were 1.5 times greater than patients covered by private payers or all other non-WC payers (P = 0.002).
CONCLUSIONS
WC patients undergo discectomy significantly less often than non-WC counterparts, which may be related to a higher risk of reoperation. New evidence-based treatments, such as annular repair, may be critical to advancing care in this unique population.
目的
本研究旨在更好地了解在工人赔偿（WC）人群中与其他支付类型相比，腰椎间盘突出症（LDH）的当前治疗趋势和翻修率。
方法
这是对佛罗里达州和纽约 2014 年至 2016 年门诊索赔数据的回顾性分析。
结果
在佛罗里达州（15%比 19%；P < 0.001）和纽约（10%比 15%；P < 0.001），WC 患者接受椎间盘切除术的可能性较小。与私人支付者或所有其他非 WC 支付者相比，WC 患者接受翻修椎间盘切除术的可能性增加了 1.5 倍（P = 0.002）。
结论
与非 WC 患者相比，WC 患者接受椎间盘切除术的频率明显降低，这可能与再次手术的风险较高有关。环状修复等新的循证治疗方法可能对推进这一独特人群的护理至关重要。
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