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- Access to Care (1)
- Adverse Events (2)
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- Back Health and Pain (1)
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- Cancer: Breast Cancer (1)
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- Policy (1)
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AHRQ Research Studies
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Research Studies is a compilation of published research articles funded by AHRQ or authored by AHRQ researchers.
Results
1 to 25 of 25 Research Studies DisplayedFeldman AG, Marsh R, Kempe A
Barriers to pretransplant immunization: a qualitative interview study of pediatric solid organ transplant stakeholders.
Investigators described the experiences and beliefs of pediatric transplant stakeholders regarding factors that contribute to low pre-transplant immunization rates. Five central themes emerged: gaps in knowledge about timing and safety of pre-transplant immunizations; lack of communication, coordination, and follow-up between team members; lack of centralized immunization records; subspecialty clinics functioning as the medical home for transplant candidates, but not able to provide all needed immunizations; and differences between organ type in prioritization and completion of pre-transplant immunization. The authors recommended new tools to overcome these barriers and to increase immunization rates in transplant candidates.
AHRQ-funded; HS026510.
Citation: Feldman AG, Marsh R, Kempe A .
Barriers to pretransplant immunization: a qualitative interview study of pediatric solid organ transplant stakeholders.
J Pediatr 2020 Dec;227:60-68. doi: 10.1016/j.jpeds.2020.07.038..
Keywords: Children/Adolescents, Transplantation, Surgery, Healthcare Delivery, Healthcare Utilization
Kochhar A, Zhang Y, Fisher L
Analysis of the operative utilization of concurrent rhinoplasty and endoscopic sinus surgery.
Investigators sought to quantify and analyze the concurrent performance of rhinoplasty (RP) and functional endoscopic sinus surgery (FESS) using cases from the State Ambulatory Surgery Databases of California, Florida, Maryland, and New York. They found that RP with FESS more frequently involved fewer sinuses and was also less likely to involve revision rhinoplasty. Procedures combining the two had a reduction in operating room time compared to the hypothetical sum of two standalone procedures.
AHRQ-funded; HS023011.
Citation: Kochhar A, Zhang Y, Fisher L .
Analysis of the operative utilization of concurrent rhinoplasty and endoscopic sinus surgery.
Laryngoscope 2020 May;130(5):E311-E119. doi: 10.1002/lary.28031..
Keywords: Surgery, Respiratory Conditions, Healthcare Utilization
Brown CS, Yang J, Meng Z
Trends in emergency department utilization following common operations in New York State, 2005-2014.
Researchers examined emergency department (ED) utilization following three common surgeries: cholecystectomy, appendectomy, and inguinal hernia repair. A longitudinal analysis was conducted using data from the SPARCS New York (NY) administrative database on 746,633 who underwent those procedures from 2005 to 2014. Nearly 1 in 10 patients who underwent cholecystectomy or appendectomy and 1 in 20 patients went to the ED after discharge. Of those, only 9.5% cholecystectomy, 9.1% appendectomy, and 5.1% inguinal hernia repair patients were readmitted indicating possible overutilization of the ED following common operations.
AHRQ-funded; HS025778; HS000053.
Citation: Brown CS, Yang J, Meng Z .
Trends in emergency department utilization following common operations in New York State, 2005-2014.
Surg Endosc 2020 May;34(5):1994-99. doi: 10.1007/s00464-019-06975-9..
Keywords: Emergency Department, Surgery, Healthcare Utilization
Newberry CI, Casazza GC, Pruitt LC
Prescription patterns and opioid usage in sinonasal surgery.
The goal of this study was to identify factors associated with variable opioid usage and to delineate optimal prescription patterns for sinonasal surgery. The researchers found that patients used 9.3% of their full prescription and only 2.6% required a refill. The amount used was not associated with complexity of endoscopic sinus surgery, type of opiate prescribed, gender, distance living from hospital, or current opioid usage before surgery. They concluded that opioids are overprescribed after sinonasal surgery and that the amount of postoperative opiate prescribed should be greatly reduced and may be based on the specific procedures performed.
AHRQ-funded; HS024638.
Citation: Newberry CI, Casazza GC, Pruitt LC .
Prescription patterns and opioid usage in sinonasal surgery.
Int Forum Allergy Rhinol 2020 Mar;10(3):381-87. doi: 10.1002/alr.22478..
Keywords: Opioids, Medication, Pain, Surgery, Respiratory Conditions, Healthcare Utilization, Practice Patterns, Substance Abuse
Khorfan R, Schlick CJR, Yang AD
Utilization of minimally invasive surgery and its association with chemotherapy for locally advanced gastric cancer.
This study compared outcomes of patients with T3 or greater and/or N+ gastric carcinoma who had minimally invasive surgery (MIS) or traditional open surgery. Patients who received MIS had a greater likelihood of receiving postoperative chemotherapy. Patients from the National Cancer Database (21,872) from 2010 to 2015 were identified. The majority (72.2%) received open surgery although MIS rates went up during that time period. Predictors of MIS were Asian race, any insurance coverage and treatment at high-volume centers. Survival rates were higher for MIS patients although that could be explained by their increased likelihood of receiving adjuvant chemotherapy.
AHRQ-funded; HS026385.
Citation: Khorfan R, Schlick CJR, Yang AD .
Utilization of minimally invasive surgery and its association with chemotherapy for locally advanced gastric cancer.
J Gastrointest Surg 2020 Feb;24(2):243-52. doi: 10.1007/s11605-019-04410-x.
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Keywords: Surgery, Treatments, Cancer, Digestive Disease and Health, Healthcare Utilization, Patient-Centered Outcomes Research, Outcomes, Evidence-Based Practice
Chhabra KR, Fan Z, Chao GF
Impact of statewide essential health benefits on utilization of bariatric surgery.
This study looked at the utilization of bariatric surgery after it was included in the Affordable Care Act’s essential health benefits program. The program required individual and small-group insurance plans in 23 states to cover the surgery. Investigators used IBM MarketScan commercial claims data from 2009 to 2016. While bariatric surgery utilization increased in all states after ACA implementation, it was no greater in states with a bariatric surgery essential health benefit. Reasons why can be explored in further studies.
AHRQ-funded; HS000053; HS025778.
Citation: Chhabra KR, Fan Z, Chao GF .
Impact of statewide essential health benefits on utilization of bariatric surgery.
Obes Surg 2020 Jan;30(1):374-77. doi: 10.1007/s11695-019-04092-z..
Keywords: Surgery, Healthcare Utilization, Policy, Health Insurance
Leeds IL, Canner JK, Gani F
Increased healthcare utilization for medical comorbidities prior to surgery improves postoperative outcomes.
The objective of this study was to evaluate the impact of optimization of preoperative comorbidities by nonsurgical clinicians on short-term postoperative outcomes. Findings demonstrated an association between the use of nonsurgical clinician visits by comorbid patients prior to surgery and a significantly lower rate of complications. Recommendations included the prospective study of preoperative optimization as a potential mechanism for improving postoperative outcomes.
AHRQ-funded; HS024736.
Citation: Leeds IL, Canner JK, Gani F .
Increased healthcare utilization for medical comorbidities prior to surgery improves postoperative outcomes.
Ann Surg 2020 Jan;271(1):114-21. doi: 10.1097/sla.0000000000002851..
Keywords: Surgery, Outcomes, Healthcare Utilization, Patient-Centered Outcomes Research, Adverse Events
Feldman AG, Atkinson K, Wilson K
Underimmunization of the solid organ transplant population: An urgent problem with potential digital health solutions.
This paper describes ways that digital health technologies may help solid organ transplant recipients stay free from vaccine-preventable infections so they are not underimmunized at the time of transplant and thereafter. Due to vaccine hesitancy and refusal in the general population, recipients can no longer rely on herd immunity to protect them. Digital health technologies can provide accurate information about vaccine safety, efficacy and timing in the pre- and post-transplant periods; make complete immunization records universally available and easily accessible; enable communication between patients and multiple providers; and provide automated vaccine reminders to both patients and providers.
AHRQ-funded; HS026510.
Citation: Feldman AG, Atkinson K, Wilson K .
Underimmunization of the solid organ transplant population: An urgent problem with potential digital health solutions.
Am J Transplant 2020 Jan;20(1):34-39. doi: 10.1111/ajt.15605..
Keywords: Transplantation, Surgery, Healthcare Utilization, Infectious Diseases, Telehealth, Health Information Technology (HIT), Vaccination
Ellis RJ, Schlick CJR, Yang AD
Utilization and treatment patterns of cytoreduction surgery and intraperitoneal chemotherapy in the United States.
This paper discusses utilization and treatment patterns of cytoreduction surgery and intraperitoneal chemotherapy (CRS/IPC) treatment for patients with peritoneal metastases (PM) in the United States. This treatment is becoming more popular in the US. The authors used the National Inpatient Sample to identify patients from 2006 to 2015 who underwent CRS/IPC. The number of CRS/IPC treatments increased from 189 to 1540. The most common indication was for appendiceal cancer, followed by ovarian and colorectal cancers. The procedure was performed the most in large teaching hospitals. The authors recommend the creation of a national registry dedicated to cases of IPC to help evaluate further use and outcomes.
AHRQ-funded; HS000078; HS026385.
Citation: Ellis RJ, Schlick CJR, Yang AD .
Utilization and treatment patterns of cytoreduction surgery and intraperitoneal chemotherapy in the United States.
Ann Surg Oncol 2020 Jan;27(1):214-21. doi: 10.1245/s10434-019-07492-8..
Keywords: Healthcare Cost and Utilization Project (HCUP), Treatments, Cancer, Practice Patterns, Healthcare Utilization, Surgery
Vila PM, Olsen MA, Piccirillo JF
Rates of sialoendoscopy and sialoadenectomy in 5,111 adults with private insurance.
The purpose of this study was to determine frequencies and trends in sialoendoscopy and sialoadenectomy for the treatment of obstructive, non-neoplastic submandibular salivary gland disease. Researchers conducted an epidemiologic study of insurance claims from 2006 to 2013 in a large, private insurance claims database; 5,111 adults with sialadenitis who had a sialoendoscopy or submandibular gland excision were included. The results of this study indicate that the use of sialoendoscopy procedures has increased over time, while the overall rate of sialoadenectomy has decreased, but the authors conclude that both procedures are safe for the treatment of patients with sialadenitis and sialolithiasis.
AHRQ-funded; HS019455.
Citation: Vila PM, Olsen MA, Piccirillo JF .
Rates of sialoendoscopy and sialoadenectomy in 5,111 adults with private insurance.
Laryngoscope 2019 Dec 16;129(3):602-06. doi: 10.1002/lary.27243..
Keywords: Healthcare Utilization, Health Insurance, Surgery
Vu JV, Gunaseelan V, Dimick JB
Mechanisms of age and race differences in receiving minimally invasive inguinal hernia repair.
Black patients and older adults are less likely to receive minimally invasive hernia repair. In this study, the investigators explored the association between race, age, and surgeon utilization of minimally invasive surgery (MIS) with the likelihood of receiving MIS inguinal hernia repair. The investigators concluded that race differences were explained by surgeon MIS utilization, implicating access to MIS-performing surgeon as a mediator. Conversely, age disparity was independent of MIS utilization, even after adjusting for comorbidities, indicating some degree of provider bias against performing MIS repair in older patients.
AHRQ-funded; HS025778.
Citation: Vu JV, Gunaseelan V, Dimick JB .
Mechanisms of age and race differences in receiving minimally invasive inguinal hernia repair.
Surg Endosc 2019 Dec;33(12):4032-37. doi: 10.1007/s00464-019-06695-0..
Keywords: Racial and Ethnic Minorities, Surgery, Elderly, Access to Care, Healthcare Utilization
Strassle PD, Kinlaw AC, Chaumont N
Rates of elective colectomy for diverticulitis continued to increase after 2006 guideline change.
Gastroenterology 2019 Dec;157(6):1679-81.e11. doi: 10.1053/j.gastro.2019.08.045.
The purpose of this retrospective cohort study was to assess whether trends in elective and urgent/emergent colectomy changed after July 2006. The authors suggest that given the risks associated with elective colectomy, their findings demonstrate the need for a more evidence-based decision-making process, incorporating both patient preferences and patient-reported outcomes, for those considering elective colectomy for uncomplicated and some cases of complicated diverticulitis.
The purpose of this retrospective cohort study was to assess whether trends in elective and urgent/emergent colectomy changed after July 2006. The authors suggest that given the risks associated with elective colectomy, their findings demonstrate the need for a more evidence-based decision-making process, incorporating both patient preferences and patient-reported outcomes, for those considering elective colectomy for uncomplicated and some cases of complicated diverticulitis.
AHRQ-funded; HS026363.
Citation: Strassle PD, Kinlaw AC, Chaumont N .
Rates of elective colectomy for diverticulitis continued to increase after 2006 guideline change.
Gastroenterology 2019 Dec;157(6):1679-81.e11. doi: 10.1053/j.gastro.2019.08.045..
Keywords: Healthcare Cost and Utilization Project (HCUP), Surgery, Healthcare Utilization, Guidelines, Shared Decision Making, Digestive Disease and Health
Subramanian MP, Liu J, Chapman WC
Utilization trends, outcomes, and cost in minimally invasive lobectomy.
The objective of this study was to compare outcomes and hospitalization costs among patients undergoing open, video-assisted thoracoscopic surgery (VATS) and RATS lobectomy. The investigators concluded that minimally invasive approaches were associated to improved clinical outcomes compared with open lobectomy. However, only robotic-assisted lobectomy has had rapid growth in utilization. Despite additional cost, RATS lobectomy appeared to provide a viable minimally invasive alternative for general thoracic procedures.
AHRQ-funded; HS019455.
Citation: Subramanian MP, Liu J, Chapman WC .
Utilization trends, outcomes, and cost in minimally invasive lobectomy.
Ann Thorac Surg 2019 Dec;108(6):1648-55. doi: 10.1016/j.athoracsur.2019.06.049..
Keywords: Healthcare Cost and Utilization Project (HCUP), Surgery, Healthcare Costs, Healthcare Utilization, Outcomes
Wissel BD, Greiner HM, Glauser TA
Investigation of bias in an epilepsy machine learning algorithm trained on physician notes.
Racial disparities in the utilization of epilepsy surgery are well documented, but it is unknown whether a natural language processing (NLP) algorithm trained on physician notes would produce biased recommendations for epilepsy presurgical evaluations. To assess this, an NLP algorithm was trained to identify potential surgical candidates using 1097 notes from 175 epilepsy patients with a history of resective epilepsy surgery and 268 patients who achieved seizure freedom without surgery (total N = 443 patients).
AHRQ-funded; HS024977.
Citation: Wissel BD, Greiner HM, Glauser TA .
Investigation of bias in an epilepsy machine learning algorithm trained on physician notes.
Epilepsia 2019 Sep;60(9):e93-e98. doi: 10.1111/epi.16320..
Keywords: Neurological Disorders, Surgery, Clinical Decision Support (CDS), Healthcare Utilization, Health Information Technology (HIT), Shared Decision Making
Ganguli I, Lupo C, Mainor AJ
Prevalence and cost of care cascades after low-value preoperative electrocardiogram for cataract surgery in fee-for-service Medicare beneficiaries.
This study examined the use and outcomes of preoperative electrocardiogram (EKG) for cataract surgery recipients on Medicare. The outcomes measured were cascade events if the EKG results were problematic. The study compared 110,183 cataract surgery recipients with 97,775 non-surgery participants (63.1% female). For the recipient group, 12,408 (11.3%) received a preoperative EKG (65.6% of them were female). Of those, 1978 (15.9%) had at least 1 potential cascade event. Additional tests, treatments, and cardiology visits added an additional estimated $35 million in addition to the $3.2 million spent on preoperative EKGs. Preoperative EKG recipients who were older, had more chronic conditions, lived in more cardiologist-dense areas, or had their EKG performed by a cardiac specialist rather than a primary care physician were more likely to experience a cascade event.
AHRQ-funded; HS023812.
Citation: Ganguli I, Lupo C, Mainor AJ .
Prevalence and cost of care cascades after low-value preoperative electrocardiogram for cataract surgery in fee-for-service Medicare beneficiaries.
JAMA Intern Med 2019 Sep;179(9):1157-308. doi: 10.1001/jamainternmed.2019.1739..
Keywords: Healthcare Costs, Medicare, Healthcare Utilization, Surgery, Elderly
Desai VB, Wright JD, Lin H
Laparoscopic hysterectomy route, resource use, and outcomes: change after power morcellation warning.
The purpose of this study was to examine changes in utilization of different types of laparoscopic hysterectomy, as well as their associated resource use and surgical outcomes, after the U.S. Food and Drug Administration (FDA) safety statement in April 2014 regarding power morcellation. They found rates of laparoscopic supracervical hysterectomy fell in association with power morcellation safety warnings, whereas rates of other laparoscopic hysterectomies continued to rise.
AHRQ-funded; HS024702.
Citation: Desai VB, Wright JD, Lin H .
Laparoscopic hysterectomy route, resource use, and outcomes: change after power morcellation warning.
Obstet Gynecol 2019 Aug;134(2):227-38. doi: 10.1097/aog.0000000000003375..
Keywords: Healthcare Utilization, Outcomes, Surgery, Women
Kirk PS, Borza T, Caram MEV
Characterising potential bone scan overuse amongst men treated with radical prostatectomy.
The authors characterized bone scan use after radical prostatectomy (RP) using data from a large, national integrated delivery system. They found a substantial rate of bone scan utilization after RP. The majority were performed for prostate-specific antigen levels in which the likelihood of a positive test was low. They recommended more judicious use of imaging in the post-RP setting.
AHRQ-funded; HS025707.
Citation: Kirk PS, Borza T, Caram MEV .
Characterising potential bone scan overuse amongst men treated with radical prostatectomy.
BJU Int 2019 Jul;124(1):55-61. doi: 10.1111/bju.14551..
Keywords: Cancer: Prostate Cancer, Cancer, Surgery, Imaging, Healthcare Utilization
Dy CJ, Brown DS, Maryam H
Two-state comparison of total joint arthroplasty utilization following Medicaid expansion.
The aim of this study was to determine whether Medicaid expansion was associated with increased utilization rates of total hip arthroplasty (THA) and total knee arthroplasty (TKA) in Illinois (which expanded Medicaid) relative to Missouri (which did not expand Medicaid). The investigators concluded that their study demonstrated that Medicaid expansion in Illinois was associated with increased utilization of THA and TKA. They suggested that further study is needed to understand the impact of Medicaid expansion in other states and for other procedures.
AHRQ-funded; HS019455.
Citation: Dy CJ, Brown DS, Maryam H .
Two-state comparison of total joint arthroplasty utilization following Medicaid expansion.
J Arthroplasty 2019 Apr;34(4):619-25.e1. doi: 10.1016/j.arth.2018.12.019..
Keywords: Healthcare Utilization, Medicaid, Orthopedics, Surgery
Martin BI, Mirza SK, Spina N
Trends in lumbar fusion procedure rates and associated hospital costs for degenerative spinal diseases in the United States, 2004 to 2015.
This study analyzed trends in lumbar fusion procedure rates for degenerative spinal diseases in the US from 2004 to 2015 as well as associated hospital costs. Spinal fusion is considered an appropriate procedure for spinal deformity and instability, but has limited evidence of effectiveness for primary disc herniation and spinal stenosis without instability. The analysis showed that aggregate hospital costs increased 177% during the analysis period with disc degeneration, herniation and stenosis accounted for 42.3% of the elective surgery. The largest increases in the elective surgery were for spondylolisthesis and scoliosis and has slightly decreased for those procedures with less evidence of effectiveness.
AHRQ-funded; HS024714.
Citation: Martin BI, Mirza SK, Spina N .
Trends in lumbar fusion procedure rates and associated hospital costs for degenerative spinal diseases in the United States, 2004 to 2015.
Spine 2019 Mar 1;44(5):369-76. doi: 10.1097/brs.0000000000002822..
Keywords: Back Health and Pain, Healthcare Cost and Utilization Project (HCUP), Healthcare Costs, Healthcare Utilization, Surgery
Lamplot JD, Bansal A, Nguyen JT
Risk of subsequent joint arthroplasty in contralateral or different joint after index shoulder, hip, or knee arthroplasty: association with index joint, demographics, and patient-specific factors.
The purpose of this study using HCUP data was to determine how demographic and other patient-specific factors are associated with the risk of subsequent joint replacement in the contralateral or a different joint following an index joint replacement for osteoarthritis. Results showed a relatively high risk of subsequent replacement of the contralateral joint and a relatively low risk of subsequent replacement of a different joint within 5 to 8 years after an index total hip arthroplasty, total knee arthroplasty, or total shoulder arthroplasty. Obesity was associated with a higher risk of subsequent replacement of the contralateral joint or a different joint.
AHRQ-funded; HS019455.
Citation: Lamplot JD, Bansal A, Nguyen JT .
Risk of subsequent joint arthroplasty in contralateral or different joint after index shoulder, hip, or knee arthroplasty: association with index joint, demographics, and patient-specific factors.
J Bone Joint Surg Am 2018 Oct 17;100(20):1750-56. doi: 10.2106/jbjs.17.00948..
Keywords: Arthritis, Healthcare Cost and Utilization Project (HCUP), Risk, Surgery, Orthopedics, Healthcare Utilization
Hilliard PE, Waljee J, Moser S
Prevalence of preoperative opioid use and characteristics associated with opioid use among patients presenting for surgery.
Researchers assessed the prevalence of preoperative opioid use and the characteristics of patients in a broadly representative surgical cohort. They found that patients undergoing lower extremity procedures were most likely to report preoperative opioid use, with 1 in 4 of all patients presenting for surgery reporting such use. They concluded that the data provided important insights into this population and would appear to help guide future preoperative optimization and perioperative opioid-weaning interventions.
AHRQ-funded; HS023313.
Citation: Hilliard PE, Waljee J, Moser S .
Prevalence of preoperative opioid use and characteristics associated with opioid use among patients presenting for surgery.
JAMA Surg 2018 Oct;153(10):929-37. doi: 10.1001/jamasurg.2018.2102..
Keywords: Opioids, Surgery, Pain, Medication, Healthcare Utilization, Orthopedics
Richards CA, Rundle AG, Wright JD
Association between hospital financial distress and immediate breast reconstruction surgery after mastectomy among women with ductal carcinoma in situ.
Hospital financial distress may reduce the services a hospital can offer, particularly unprofitable ones. This study examined the association between hospital financial distress (HFD) and receipt of immediate breast reconstruction surgery after mastectomy among women diagnosed with ductal carcinoma in situ (DCIS). It concluded that the financial strength of the hospital where a patient receives treatment is associated with receipt of immediate breast reconstruction surgery.
AHRQ-funded; HS021709.
Citation: Richards CA, Rundle AG, Wright JD .
Association between hospital financial distress and immediate breast reconstruction surgery after mastectomy among women with ductal carcinoma in situ.
JAMA Surg 2018 Apr;153(4):344-51. doi: 10.1001/jamasurg.2017.5018.
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Keywords: Cancer: Breast Cancer, Healthcare Costs, Healthcare Utilization, Healthcare Cost and Utilization Project (HCUP), Surgery
Abdel Khalik H, Stevens H, Carlin AM
Site-specific approach to reducing emergency department visits following surgery.
The aim of this study was to explore the efficacy of current bariatric perioperative measures at reducing emergency department (ED) visits following bariatric surgery in the state of Michigan. The investigators concluded that current practices aimed at reducing ED visits appeared to be ineffective. They suggested that due to heterogeneity in patient populations and local infrastructure, a more tailored approach to ED visit reduction may be more successful.
AHRQ-funded; HS023621; HS024403.
Citation: Abdel Khalik H, Stevens H, Carlin AM .
Site-specific approach to reducing emergency department visits following surgery.
Ann Surg 2018 Apr;267(4):721-26. doi: 10.1097/sla.0000000000002226.
Keywords: Adverse Events, Emergency Department, Healthcare Utilization, Obesity, Surgery
Ellimoottil C, Miller S, Ayanian JZ
Effect of insurance expansion on utilization of inpatient surgery.
The researchers examined the differential effect of the Massachusetts insurance expansion on the use of discretionary vs. nondiscretionary surgical procedures. They found that discretionary surgery increased 9.3 percent while nondiscretionary surgery decreased by 4.5 percent. The greatest increase in discretionary surgery was observed for nonwhite participants.
AHRQ-funded; HS018346.
Citation: Ellimoottil C, Miller S, Ayanian JZ .
Effect of insurance expansion on utilization of inpatient surgery.
JAMA Surg. 2014 Aug;149(8):829-36. doi: 10.1001/jamasurg.2014.857..
Keywords: Healthcare Cost and Utilization Project (HCUP), Surgery, Health Insurance, Healthcare Utilization
Martin BI, Franklin GM, Deyo RA
How do coverage policies influence practice patterns, safety, and cost of initial lumbar fusion surgery? A population-based comparison of workers' compensation systems.
In response to increasing use of lumbar fusion for improving back pain, despite unclear efficacy, particularly among injured workers, this study compared the use of complex fusion techniques, adverse outcomes within 3 months, and costs for California and Washington State with workers’ compensation policies that differed in their coverage restrictions. The researchers found that California’s broader coverage policy was associated with more aggressive practice, higher rates of reoperation, readmission and other complications.
AHRQ-funded; HS018405
Citation: Martin BI, Franklin GM, Deyo RA .
How do coverage policies influence practice patterns, safety, and cost of initial lumbar fusion surgery? A population-based comparison of workers' compensation systems.
Spine J. 2014 Jul;14(7):1237-46. doi: 10.1016/j.spinee.2013.08..
Keywords: Health Insurance, Surgery, Healthcare Costs, Healthcare Utilization