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 ba ck pain (LBP) hospitalizations through time and among geographic regio ns and to explore the practical implications of these patterns for hea lth care reform. Setting. For time trends, the U.S. (1979-1987); for g eographic variations, major regions of the U.S. (1987). Date Source: T he National Hospital Discharge Survey. Results: Rates of both surgical and nonsurgical LBP hospitalization varied twofold among regions of t he U.S., and average lengths of stay for these types of hospitalizatio n varied considerably as well. The U.S. rate of LBP surgery increased sharply during the period covered by the study. Over the same time, th e U.S. rate of nonsurgical LBP hospitalization declined, as did averag e lengths of stay for both types of LBP hospitalization. Conclusion: W ide variations in LBP hospitalization practices raise the issue of whi ch practices are most appropriate. Outcomes research addresses this is sue, as does research on patient preferences for certain types of trea tment. As indicated by the increasing rate of LBP surgery, more resear ch also needs to be done on changing physician practice style. If such research were to result in a reduction in LBP hospitalization, saving s in health care costs would be considerable.