Patterns in low back pain hospitalizations: implications for the treatment of low back pain in an era of health care reform.
OBJECTIVE
To examine patterns in both surgical and nonsurgical low back pain (LBP) hospitalizations through time and among geographic regions and to explore the practical implications of these patterns for health care reform.


METHODS
For time trends, the U.S. (1979-1987); for geographic variations, major regions of the U.S. (1987). DATE SOURCE: The National Hospital Discharge Survey.


RESULTS
Rates of both surgical and nonsurgical LBP hospitalization varied twofold among regions of the U.S., and average lengths of stay for these types of hospitalization varied considerably as well. The U.S. rate of LBP surgery increased sharply during the period covered by the study. Over the same time, the U.S. rate of nonsurgical LBP hospitalization declined, as did average lengths of stay for both types of LBP hospitalization.


CONCLUSIONS
Wide variations in LBP hospitalization practices raise the issue of which practices are most appropriate. Outcomes research addresses this issue, as does research on patient preferences for certain types of treatment. As indicated by the increasing rate of LBP surgery, more research also needs to be done on changing physician practice style. If such research were to result in a reduction in LBP hospitalization, savings in health care costs would be considerable.
Volinn
E
E
Multidisciplinary Pain Center, University of Washington, Seattle 98195.
Turczyn
K M
KM
Loeser
J D
JD
D001416:Back Pain / Q000601:surgery / Q000628:therapy*; D018166:Health Care Reform; D006306:Health Surveys; D006760:Hospitalization / Q000639:trends; D006801:Humans; D007902:Length of Stay; D008161:Lumbosacral Region; D014481:United States