Geographic Variation in Spine Care Among Injured Workers

Details

• Personal Author:
  Rischitelli G
• Description:
  This project addressed two National Occupational Research Agenda priority areas: occupational health services research and low back pain. Back pain among workers is an enormous medical, social, and economic burden in the United States. Back disorders account for 27% of all disabling occupational injuries in the United States and the average direct cost of a low back injury claim is more than twice that of other occupational injury claims combined. Surgical interventions are responsible for nearly one-third of the health care costs for workers with back injury. There is a lack of consensus among physicians, however, about the appropriate use of surgical interventions that result in large regional variations in care. The primary goal of the study was to examine community differences in the rate and types of spinal surgery performed on injured workers using small area analysis. Small area analysis is a commonly employed method in health services research but there have been limited applications of this technique in occupational health research. Oregon, as well as a number of neighboring Western states, has been identified as having elevated rates of spine surgery compared to the rest of the nation and significant local variation exists among communities based on prior analyses of Medicare claims data. The study was designed to evaluate whether a similar pattern of local variation existed for workers' compensation claims and to evaluate factors contributing to observed variations including physician specialty, physician supply, source of payment, and the effect of managed care. This project piloted the use of an existing state database of workers' compensation medical payments. [Description provided by NIOSH]
• Subjects:
  Musculoskeletal Diseases Occupational Health Safety Workload
• Keywords:
  Analytical-processes Back-injuries Injuries Statistical-analysis Surgery Traumatic-injuries Work-capability Work-capacity Worker-health Workers
• Series:
  Grant Final Reports
• Publisher:
  National Institute for Occupational Safety and Health
• Document Type:
  Text
• Funding:
  Grant
• Genre:
  Final Grant Report
• Place as Subject:
  Oregon ; OSHA Region 10
• CIO:
  National Institute for Occupational Safety and Health (NIOSH)
• Division:
  OEP - Office of Extramural Programs
• Topic:
  Workplace Safety & Health
• Location:
  North America
• Pages in Document:
  1-26
• NIOSHTIC Number:
  nn:20043257
• NTIS Accession Number:
  PB2014-100560
• Citation:
  Atlanta, GA: U.S. Department of Health and Human Services, Public Health Service, Centers for Disease Control and Prevention, National Institute for Occupational Safety and Health, K01-OH-007922, 2010 Jan; :1-26
• Contact Point Address:
  Donald G. Rischitelli, MD, JD, MPH, Center for Research on Occupational and Environmental Toxicology, Oregon Health & Science University, 3181 SW Sam Jackson Park Road, Portland, OR 97239
• Email:
  rischiten@ohsu.edu
• Federal Fiscal Year:
  2010
• Performing Organization:
  Oregon Health & Science University
• Peer Reviewed:
  False
• Start Date:
  20030930
• Source Full Name:
  National Institute for Occupational Safety and Health
• End Date:
  20060929
• Collection(s):
  National Institute for Occupational Safety and Health
• Main Document Checksum:
  urn:sha-512:bc52de76cf3dcf4c0b47a9a6c71ff0740b2bbe69d865456afa8d9b27bc3ce32d1f4440f867fb7756df9d8a1b59dc05a7b4920c6dbed0072ad8868b703dfc47a3
• Download URL:
  https://stacks.cdc.gov/view/cdc/218533/cdc_218533_DS1.pdf
• File Type:
  [PDF - 604.41 KB ]