Studies from Yale University Further Understanding of Managed Care (Changes In the Utilization of Lumbosacral Epidural Injections Between 2010 and 2019): Managed Care

2022 DEC 02 (NewsRx) -- By a News Reporter-Staff News Editor at Health Policy and Law Daily -- Current study results on Managed Care have been published. According to news originating from New Haven, Connecticut, by NewsRx correspondents, research stated, “A descriptive epidemiologic study. To analyze trends and patient characteristics for lumbosacral transforaminal and interlaminar/caudal epidural injection utilization over time.”

Our news journalists obtained a quote from the research from Yale University, “Lumbosacral transforaminal and interlaminar/caudal epidural injections are considered for varying lumbar pathologies. Reported studies, physician practices, insurance authorization, and other factors may influence utilization patterns over time. Patients undergoing lumbosacral transforaminal and interlaminar/caudal epidural injections between 2010 and 2019 were identified in the M91Ortho PearlDiver database based on Current Procedural Terminology coding. Patient age, sex, Elixhauser Comorbidity Index (ECI), insurance plan (commercial, Medicaid, Medicare), and region of the country where the procedure was performed (Midwest, Northeast, South, West) were assessed and tracked over the years studied based on prevalence per 100,000 covered lives. Lumbosacral transforaminal and interlaminar/caudal epidural injections were identified for 426,039 and 501,228 patients, respectively. The number of injections performed per year decreased over the years studied: for transforaminal injections from 160.81 to 76.36 per 100,000 patients and for interlaminar/caudal injections from 200.53 to 77.56 per 100,000 patients. The decrease in overall injections was greatest for those with Commercial and Medicare coverage (53.40% and 66.50%, respectively), with a smaller drop amongst those with Medicaid coverage (32.39%). Over the years, the average patient undergoing injection was older and there was a relative shift toward transforaminal injections (P <0.05 for both). In terms of specialty of those performing the injections, they were mostly performed by Anesthesiology specialists (who performed less transforaminal than interlaminar/caudal injections). Lumbosacral transforaminal and interlaminar/caudal spinal epidural injections were shown to decrease by 52.37% per 100,000 patients from 2010 to 2019. Changing demographics of those undergoing such injections and practice patterns are important to consider in the picture of overall spine service utilization.”

According to the news editors, the research concluded: “Variations in injection utilization trends by patient insurance raise questions regarding disparities in care.”

This research has been peer-reviewed.

For more information on this research see: Changes In the Utilization of Lumbosacral Epidural Injections Between 2010 and 2019. Spine, 2022;47(23):1669-1674. Spine can be contacted at: Lippincott Williams & Wilkins, Two Commerce Sq, 2001 Market St, Philadelphia, PA 19103, USA. (Lippincott Williams and Wilkins - www.lww.com; Spine - http://journals.lww.com/spinejournal/pages/default.aspx)

The news correspondents report that additional information may be obtained from Jonathan N. Grauer, Yale University, School of Medicine, Dept. of Orthopaedics and Rehabilitation, 47 Coll St, New Haven, CT 06510, United States. Additional authors for this research include Philip P. Ratnasamy, Michael J. Gouzoulis, Alexander J. Kammien and Eric K. Holder.

The direct object identifier (DOI) for that additional information is: https://doi.org/10.1097/brs.0000000000004467. This DOI is a link to an online electronic document that is either free or for purchase, and can be your direct source for a journal article and its citation.

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