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私人保险人群中骶髂关节融合术的成本及使用趋势

Trends in Sacroiliac Joint Fusion Costs and Utilization in the Privately Insured Population.

作者信息

Johnstone Thomas, Schonfeld Ethan, Sadeghzadeh Sina, Marianayagam Neelan J, Yoo Kelly H, Ratliff John K, Veeravagu Anand

机构信息

School of Medicine, Stanford University, Stanford, CA, USA.

Department of Neurosurgery, Stanford Hospital, Stanford, CA, USA.

出版信息

Global Spine J. 2024 Dec 17:21925682241309302. doi: 10.1177/21925682241309302.

Abstract

STUDY DESIGN

Retrospective Cohort Study.

OBJECTIVE

Despite innovations in minimally invasive (MI) techniques for sacroiliac joint fusion (SIJF), trends in utilization and associated costs remain unclear. In this study, we assessed these trends and costs in a database of privately insured patients.

METHODS

Records of open and MI SIJFs were queried from the 2007-2021 MarketScan Databases with CPT codes. Net payments made by insurance carriers were identified, as were out-of-pocket payments made by patients for each encounter. Regression was used to model utilization, payments, and costs.

RESULTS

4124 SIJFs were identified, 1626 (39.4%) of which were MI SIJF. SIJF utilization increased by 1176.2% throughout the study period ( < .001). However, open SIJF utilization peaked in 2012. Open SIJF utilization was not significantly associated with time ( = .18). By contrast, the peak utilization for MI procedures occurred in 2021. Spine surgeons' volume of MI SIJF increased by 258% over the study period ( < .001), while nonsurgeon volume of MI SIJF increased by 990.9% ( < .001).

CONCLUSION

Privately insured patients have increasingly utilized SIJF over the past several years. This is predominantly due to the adoption of MI techniques by spine surgeons and nonsurgeons.

摘要

研究设计

回顾性队列研究。

目的

尽管骶髂关节融合术(SIJF)的微创(MI)技术有所创新,但其使用趋势和相关成本仍不明确。在本研究中,我们在一个私人保险患者数据库中评估了这些趋势和成本。

方法

从2007 - 2021年市场扫描数据库中查询开放性和MI SIJF的记录,并使用现行程序编码(CPT)。确定了保险公司支付的净费用以及患者每次就诊的自付费用。采用回归分析对使用情况、支付费用和成本进行建模。

结果

共识别出4124例SIJF,其中1626例(39.4%)为MI SIJF。在整个研究期间,SIJF的使用量增加了1176.2%(P <.001)。然而,开放性SIJF的使用量在2012年达到峰值。开放性SIJF的使用量与时间无显著相关性(P =.18)。相比之下,MI手术的使用量峰值出现在2021年。在研究期间,脊柱外科医生进行的MI SIJF手术量增加了258%(P <.001),而非外科医生进行的MI SIJF手术量增加了990.9%(P <.001)。

结论

在过去几年中,私人保险患者越来越多地使用SIJF。这主要归因于脊柱外科医生和非外科医生对MI技术的采用。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/3a5c/12127677/286a1c1fcb34/10.1177_21925682241309302-fig1.jpg

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