title: United States hospital admissions for lumbar spinal stenosis: racial and ethnic differences, 2000 through 2009.
abstract: METHODS
  Retrospective analysis of Nationwide Inpatient Sample and US Census data.
  
  
  OBJECTIVE
  To (1) document national trends in surgical hospitalizations with the primary diagnosis of lumbar spinal stenosis from 2000 through 2009; and (2) evaluate how those trends relate to race and ethnicity.
  
  
  BACKGROUND
  In the United States, the rate of lumbar spinal stenosis surgery is increasing, and understanding how changing demographic trends impact hospitalization rates for this surgery is important.
  
  
  METHODS
  Multivariable regression models were used to determine associations between race and ethnicity and the rates of surgical hospitalization for lumbar spinal stenosis. All models were adjusted for age, sex, insurance, income status, geographical location, and comorbidities.
  
  
  RESULTS
  From 2000 through 2009, the overall surgical hospitalization rate increased by 30%. Surgical hospitalization rates for lumbar spinal stenosis in the United States varied substantially across racial and ethnic groups. In 2009, white, non-Hispanics had the highest rate (1.074 per 1000) compared with black, non-Hispanics (0.558 per 1000; P< 0.001), and Hispanics (0.339 per 1000; P< 0.001). The relative differences persisted across time.
  
  
  CONCLUSIONS
  There were substantial differences in rates of surgical hospitalization among individuals of different racial and ethnic groups. Possible causes were (1) differences in clinical decision making among spine care providers with regard to offering surgical care to minority populations; (2) differences in access to care because of financial, educational, or geographical barriers; and (3) differences in attitudes toward surgical care among those of different racial and ethnic groups.
  
  
  METHODS
  3.
authors.affiliation: Departments of *Orthopaedic Surgery †Health Policy and Management, and ‡Physical Medicine and Rehabilitation, The Johns Hopkins University, Baltimore, MD.
authors.forename: Richard L
authors.initials: RL
authors.lastname: Skolasky
authors.forename: Anica M
authors.initials: AM
authors.lastname: Maggard
authors.forename: Roland J
authors.initials: RJ
authors.lastname: Thorpe
authors.forename: Stephen T
authors.initials: ST
authors.lastname: Wegener
authors.forename: Lee H
authors.initials: LH
authors.lastname: Riley
mesh_terms: D001741:Black or African American / Q000706:statistics & numerical data; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D006297:Health Services Accessibility / Q000706:statistics & numerical data; D054625:Healthcare Disparities / Q000706:statistics & numerical data / Q000639:trends; D006630:Hispanic or Latino / Q000706:statistics & numerical data; D006760:Hospitalization / Q000706:statistics & numerical data; D006801:Humans; D008159:Lumbar Vertebrae / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D010343:Patient Admission / Q000706:statistics & numerical data*; D012044:Regression Analysis; D012189:Retrospective Studies; D013130:Spinal Stenosis / Q000175:diagnosis / Q000208:ethnology* / Q000601:surgery*; D014481:United States; D044465:White People / Q000706:statistics & numerical data