2000 年至 2018 年在 Medicare 按服务收费人群中骶髂关节注射的利用模式。

Utilization Patterns of Sacroiliac Joint Injections from 2000 to 2018 in Fee-for-Service Medicare Population.

机构信息

Pain Management Centers of America, Paducah, KY and Evansville, IN; LSU Health Science Center, New Orleans, LA.

University of Kentucky, Lexington KY.

出版信息

Pain Physician. 2020 Sep;23(5):439-450.

PMID:32967386

Abstract

BACKGROUND

Sacroiliac joint is one of the proven causes of low back and lower extremity pain. Prevalence estimates of sacroiliac joint pain range from 10% to 25% in patients with persistent axial low back pain without disc herniation, discogenic pain, or radiculitis based on multiple diagnostic studies and systematic reviews. Over the years, utilization patterns of sacroiliac joint injections have been increasing in comparison to other interventional techniques. Further, the development of new current procedural terminology (CPT) codes and coverage policies for sacroiliac joint nerve blocks, sacroiliac joint radiofrequency neurotomy, and evolving evidence for sacroiliac joint fusion will further increase the utilization patterns.

STUDY DESIGN

Analysis of growth patterns of sacroiliac joint injections from 2000 to 2018 with comparative analysis of 2000 to 2009 and 2009 to 2018.

OBJECTIVES

To assess utilization patterns of sacroiliac joint injections from 2000 to 2018.

METHODS

The Centers for Medicare and Medicaid Services (CMS) Physician/Supplier Procedure Summary (PSPS) Master dataset was utilized in this analysis.

RESULTS

The results of the evaluation from 2009 to 2018 showed an increase of 11.3% and an annual increase of 1.2% per 100,000 Medicare population. However, from 2000 to 2009, an increase of 299.8% from 2000 to 2009 with an annual increase of 16.6% per 100,000 Medicare population.

LIMITATIONS

The limitations of this study included a lack of data on the new sacroiliac joint nerve block and radiofrequency neurotomy codes. Further, this data did not include utilization patterns of sacroiliac joint fusions. In addition, Medicare Advantage patients were not included, which constitute approximately 30% of overall Medicare population. Further, there is also a possibility that state claims data may include claims from other states. As with all claims-based data analyses, this study is retrospective and thus potentially limited by bias. Finally, patients who are self or commercially insured are not part of the dataset.

CONCLUSIONS

This study shows increases in utilization patterns of sacroiliac joint injections; however, at a significantly lower rate with an annual increase of 16.6% prior to 2009 and only 1.2% from 2009 to 2018 per 100,000 Medicare beneficiaries.

摘要

背景

骶髂关节是导致下腰痛和下肢痛的已知原因之一。多项诊断研究和系统评价显示，在无椎间盘突出、椎间盘源性疼痛或神经根炎的持续性轴向下腰痛患者中，骶髂关节疼痛的患病率估计为 10%至 25%。多年来，与其他介入技术相比，骶髂关节注射的应用模式一直在增加。此外，新的当前程序术语 (CPT) 代码和骶髂关节神经阻滞、骶髂关节射频神经切断术的覆盖政策的发展，以及骶髂关节融合的不断发展的证据，将进一步增加应用模式。

研究设计

分析 2000 年至 2018 年骶髂关节注射的增长模式，并对 2000 年至 2009 年和 2009 年至 2018 年进行比较分析。

目的

评估 2000 年至 2018 年骶髂关节注射的应用模式。

方法

本分析使用了医疗保险和医疗补助服务中心 (CMS) 医生/供应商程序摘要 (PSPS) 主数据集。

结果

2009 年至 2018 年的评估结果显示，每 10 万医疗保险人口增加 11.3%，年增长率为 1.2%。然而，从 2000 年到 2009 年，增长了 299.8%，每 10 万医疗保险人口的年增长率为 16.6%。

局限性

本研究的局限性包括缺乏新的骶髂关节神经阻滞和射频神经切断术代码的数据。此外，这项数据不包括骶髂关节融合的应用模式。此外，医疗保险优势患者未包括在内，约占整体医疗保险人口的 30%。此外，州索赔数据也可能包括来自其他州的索赔。与所有基于索赔的数据分析一样，本研究是回顾性的，因此可能受到偏见的限制。最后，自费或商业保险的患者不属于数据集的一部分。